Risk of subsequent gliomas and meningiomas among 69,460 5-year survivors of childhood and adolescent cancer in Europe: the PanCareSurFup study
: Heymer, Emma J.; Hawkins, Michael M.; Winter, David L.; Teepen, Jop C.; Sunguc, Ceren; Ronckers, Cécile M.; Allodji, Rodrigue S.; Alessi, Daniela; Sugden, Elaine; Belle, Fabiën N.; Bagnasco, Francesca; Byrne, Julianne; Bárdi, Edit; Garwicz, Stanislaw; Grabow, Desiree; Jankovic, Momcilo; Kaatsch, Peter; Kaiser, Melanie; Michel, Gisela; Schindera, Christina; Haddy, Nadia; Journy, Neige; Česen Mazić, Maja; Skinner, Roderick; Kok, Judith L.; Gunnes, Maria W.; Wiebe, Thomas; Sacerdote, Carlotta; Maule, Milena M.; Terenziani, Monica; Jakab, Zsuzsanna; Winther, Jeanette F.; Lähteenmäki, Päivi M.; Zadravec Zaletel, Lorna; Haupt, Riccardo; Kuehni, Claudia E.; Kremer, Leontien C.; de Vathaire, Florent; Hjorth, Lars; Reulen, Raoul C.
Publisher: Springer Nature
: 2024
British Journal of Cancer
: British Journal of Cancer
: 130
: 6
: 976
: 986
: 0007-0920
: 1532-1827
DOI: https://doi.org/10.1038/s41416-024-02577-y
: https://www.nature.com/articles/s41416-024-02577-y
: https://research.utu.fi/converis/portal/detail/Publication/386790060
Background: Childhood cancer survivors are at risk of subsequent gliomas and meningiomas, but the risks beyond age 40 years are uncertain. We quantified these risks in the largest ever cohort.
Methods: Using data from 69,460 5-year childhood cancer survivors (diagnosed 1940-2008), across Europe, standardized incidence ratios (SIRs) and cumulative incidence were calculated.
Results: In total, 279 glioma and 761 meningioma were identified. CNS tumour (SIR: 16.2, 95% CI: 13.7, 19.2) and leukaemia (SIR: 11.2, 95% CI: 8.8, 14.2) survivors were at greatest risk of glioma. The SIR for CNS tumour survivors was still 4.3-fold after age 50 (95% CI: 1.9, 9.6), and for leukaemia survivors still 10.2-fold after age 40 (95% CI: 4.9, 21.4). Following cranial radiotherapy (CRT), the cumulative incidence of a glioma in CNS tumour survivors was 2.7%, 3.7% and 5.0% by ages 40, 50 and 60, respectively, whilst for leukaemia this was 1.2% and 1.7% by ages 40 and 50. The cumulative incidence of a meningioma after CRT in CNS tumour survivors doubled from 5.9% to 12.5% between ages 40 and 60, and in leukaemia survivors increased from 5.8% to 10.2% between ages 40 and 50.
Discussion: Clinicians following up survivors should be aware that the substantial risks of meningioma and glioma following CRT are sustained beyond age 40 and be vigilant for symptoms.
