Advanced

Life years lost-comparing potentially fatal late complications after radiotherapy for pediatric medulloblastoma on a common scale

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. (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:
author
organization
publishing date
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
external identifiers
  • wos:000310083000029
  • scopus:84867863152
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
2013-01-07 09:41:20
date last changed
2017-06-18 03:22:06
@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},
  keyword      = {life years lost,radiotherapy,late effects,secondary cancers,risk,modeling},
  language     = {eng},
  number       = {21},
  pages        = {5432--5440},
  publisher    = {John Wiley & Sons},
  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},
  volume       = {118},
  year         = {2012},
}