Guidelines for Complications of Cancer Treatment Vol VIII Part B

Suggested Reading:1. Goldsby R, Burke C, Nagarajan R, et al: Second solidmalignancies among children, adolescents, and youngadults diagnosed with malignant bone tumors after 1976:follow-up of a Children’s Oncology Group cohortCancer 2008;113((9):2597-2604BACKGROUND: The growing number of individualssurviving childhood cancer has increased the awareness ofadverse long-term sequelae. One of the most worrisomecomplications after cancer therapy is the development ofsecond malignant neoplasms (SMNs).METHODS: The authors describe the incidence of solid organSMN in survivors of pediatric malignant bone tumors whowere treated on legacy Children’s Cancer Group/PediatricOncology Group protocols from 1976 to 2005. Thisretrospective cohort study included 2842 patients: 1686 whowere treated for osteosarcoma (OS) and 1156 who were treatedfor Ewing sarcoma (ES).RESULTS: The cohort included 56% boys/young men and44% girls/young women, and the median age at primarydiagnosis was 13 years. The median length of follow-up was6.1 years (range, 0-20.9 years). In this analysis, 64% of patientswere alive. Seventeen patients with solid organ SMN wereidentified. The standardized incidence ratio was 2.9 (95%confidence interval [CI], 1.4-5.4) for patients who were treatedfor OS and 5.0 (95% CI, 2.6-9.4) for patients who were treatedfor ES. The median time from diagnosis to development ofsolid SMN was 7 years (range, 1-13 years). The 10-yearcumulative incidence of solid organ SMN for the entire cohortwas 1.4% (95%CI 0.6%-2%).CONCLUSIONS: The magnitude of risk of solid SMNs wasmodest after treatment for malignant bone tumors. However,292