Life years lost-comparing potentially fatal late complications after radiotherapy for pediatric medulloblastoma on a common scale
(2012) In Cancer 118(21). p.5432-5440- Abstract
- BACKGROUND: The authors developed a framework for estimating and comparing the risks of various long-term complications on a common scale and applied it to 3 different techniques for craniospinal irradiation in patients with pediatric medulloblastoma. METHODS: Radiation dose-response parameters related to excess hazard ratios for secondary breast, lung, stomach, and thyroid cancer; heart failure, and myocardial infarction were derived from large published clinical series. Combined with age-specific and sex-specific hazards in the US general population, the dose-response analysis yielded excess hazards of complications for a cancer survivor as a function of attained age. After adjusting for competing risks of death, life years lost (LYL)... (More)
- BACKGROUND: The authors developed a framework for estimating and comparing the risks of various long-term complications on a common scale and applied it to 3 different techniques for craniospinal irradiation in patients with pediatric medulloblastoma. METHODS: Radiation dose-response parameters related to excess hazard ratios for secondary breast, lung, stomach, and thyroid cancer; heart failure, and myocardial infarction were derived from large published clinical series. Combined with age-specific and sex-specific hazards in the US general population, the dose-response analysis yielded excess hazards of complications for a cancer survivor as a function of attained age. After adjusting for competing risks of death, life years lost (LYL) were estimated based on excess hazard and prognosis of a complication for 3-dimensional conformal radiotherapy (3D CRT), volumetric modulated arc therapy (VMAT), and intensity-modulated proton therapy (IMPT). RESULTS: Lung cancer contributed most to the estimated LYL, followed by myocardial infarction, and stomach cancer. The estimates of breast or thyroid cancer incidence were higher than those for lung and stomach cancer incidence, but LYL were lower because of the relatively good prognosis. Estimated LYL ranged between 1.90 years for 3D CRT to 0.28 years for IMPT. In a paired comparison, IMPT was associated with significantly fewer LYL than both photon techniques. CONCLUSIONS: Estimating the risk of late complications is associated with considerable uncertainty, but including prognosis and attained age at an event to obtain the more informative LYL estimate added relatively little to this uncertainty. Cancer 2012. (c) 2012 American Cancer Society. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3283512
- author
- Brodin, N. Patrik ; Vogelius, Ivan R. ; Maraldo, Maja V. ; af Rosenschold, Per Munck ; Aznar, Marianne C. ; Kiil-Berthelsen, Anne ; Nilsson, Per LU ; Björk-Eriksson, Thomas ; Specht, Lena and Bentzen, Soren M.
- organization
- publishing date
- 2012
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- life years lost, radiotherapy, late effects, secondary cancers, risk, modeling
- in
- Cancer
- volume
- 118
- issue
- 21
- pages
- 5432 - 5440
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- wos:000310083000029
- scopus:84867863152
- pmid:22517408
- ISSN
- 1097-0142
- DOI
- 10.1002/cncr.27536
- language
- English
- LU publication?
- yes
- id
- 09ee2b0a-bacc-4e41-861a-b069d499a712 (old id 3283512)
- date added to LUP
- 2016-04-01 10:52:45
- date last changed
- 2022-03-04 23:41:27
@article{09ee2b0a-bacc-4e41-861a-b069d499a712, abstract = {{BACKGROUND: The authors developed a framework for estimating and comparing the risks of various long-term complications on a common scale and applied it to 3 different techniques for craniospinal irradiation in patients with pediatric medulloblastoma. METHODS: Radiation dose-response parameters related to excess hazard ratios for secondary breast, lung, stomach, and thyroid cancer; heart failure, and myocardial infarction were derived from large published clinical series. Combined with age-specific and sex-specific hazards in the US general population, the dose-response analysis yielded excess hazards of complications for a cancer survivor as a function of attained age. After adjusting for competing risks of death, life years lost (LYL) were estimated based on excess hazard and prognosis of a complication for 3-dimensional conformal radiotherapy (3D CRT), volumetric modulated arc therapy (VMAT), and intensity-modulated proton therapy (IMPT). RESULTS: Lung cancer contributed most to the estimated LYL, followed by myocardial infarction, and stomach cancer. The estimates of breast or thyroid cancer incidence were higher than those for lung and stomach cancer incidence, but LYL were lower because of the relatively good prognosis. Estimated LYL ranged between 1.90 years for 3D CRT to 0.28 years for IMPT. In a paired comparison, IMPT was associated with significantly fewer LYL than both photon techniques. CONCLUSIONS: Estimating the risk of late complications is associated with considerable uncertainty, but including prognosis and attained age at an event to obtain the more informative LYL estimate added relatively little to this uncertainty. Cancer 2012. (c) 2012 American Cancer Society.}}, author = {{Brodin, N. Patrik and Vogelius, Ivan R. and Maraldo, Maja V. and af Rosenschold, Per Munck and Aznar, Marianne C. and Kiil-Berthelsen, Anne and Nilsson, Per and Björk-Eriksson, Thomas and Specht, Lena and Bentzen, Soren M.}}, issn = {{1097-0142}}, keywords = {{life years lost; radiotherapy; late effects; secondary cancers; risk; modeling}}, language = {{eng}}, number = {{21}}, pages = {{5432--5440}}, publisher = {{John Wiley & Sons Inc.}}, series = {{Cancer}}, title = {{Life years lost-comparing potentially fatal late complications after radiotherapy for pediatric medulloblastoma on a common scale}}, url = {{http://dx.doi.org/10.1002/cncr.27536}}, doi = {{10.1002/cncr.27536}}, volume = {{118}}, year = {{2012}}, }