Long-term pulmonary disease among Swiss childhood cancer survivors.

Kasteler, Rahel; Weiss, Annette; Schindler, Matthias; Sommer, Grit; Latzin, Philipp; von der Weid, Nicolas X; Ammann, Roland A; Kuehni, Claudia E (2018). Long-term pulmonary disease among Swiss childhood cancer survivors. Pediatric blood & cancer, 65(1), e26749. Wiley-Liss 10.1002/pbc.26749

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BACKGROUND Pulmonary diseases are potentially severe late complications of childhood cancer treatment that increase mortality risk among survivors. This nationwide study assesses the prevalence and incidence of pulmonary diseases in long-term childhood cancer survivors (CCS) and their siblings, and quantifies treatment-related risks. METHODS As part of the Swiss Childhood Cancer Survivor Study, we studied CCS who were diagnosed between 1976 and 2005 and alive at least 5 years after diagnosis. We compared prevalence of self-reported pulmonary diseases (pneumonia, chest wall abnormalities, lung fibrosis, emphysema) between CCS and their siblings, calculated cumulative incidence of pulmonary diseases using the Kaplan-Meier method, and determined risk factors using multivariable logistic regression. RESULTS CCS reported more pneumonias (10% vs. 7%, P = 0.020) and chest wall abnormalities (2% vs. 0.4%, P = 0.003) than siblings. Treatment with busulfan was associated with prevalence of pneumonia (odds ratio [OR] 4.0, 95% confidence interval [CI] 1.1-14.9), and thoracic surgery was associated with chest wall abnormalities and lung fibrosis (OR 4.1, 95% CI 1.6-10.7 and OR 6.3, 95% CI 1.7-26.6). Cumulative incidence of any pulmonary disease after 35 years of follow-up was 21%. For pneumonia, the highest cumulative incidence was seen in CCS treated with both pulmotoxic chemotherapy and radiotherapy to the thorax (23%). CONCLUSION This nationwide study in CCS found an increased risk for pulmonary diseases, especially pneumonia, while still young, which indicates that CCS need long-term pulmonary follow-up.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)
Graduate School for Health Sciences (GHS)

UniBE Contributor:

Kasteler, Rahel; Weiss, Annette; Schindler, Matthias; Sommer, Grit; Latzin, Philipp; Ammann, Roland and Kühni, Claudia

Subjects:

300 Social sciences, sociology & anthropology > 360 Social problems & social services
600 Technology > 610 Medicine & health

ISSN:

1545-5009

Publisher:

Wiley-Liss

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

07 Sep 2017 11:50

Last Modified:

09 May 2019 16:24

Publisher DOI:

10.1002/pbc.26749

PubMed ID:

28868646

Uncontrolled Keywords:

cancer treatment; childhood cancer; late effects; lung injury; pneumonia; pulmonary disease

BORIS DOI:

10.7892/boris.105302

URI:

https://boris.unibe.ch/id/eprint/105302

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