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Marty-Diloy T, Rougereau G, Mary P, Vialle R, Fitoussi F, Pietton R, Langlais T. Induced-membrane technique for lower limb reconstruction after malignant bone tumour resection in paediatric patients: Complication and re-operation rates. Orthop Traumatol Surg Res 2024; 110:103875. [PMID: 38556207 DOI: 10.1016/j.otsr.2024.103875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/29/2023] [Accepted: 07/11/2023] [Indexed: 04/02/2024]
Abstract
BACKGROUND The objective of this study was to assess the complication and re-operation rates, evaluate the risk of non-union, and describe the functional outcomes at last follow-up in children and adolescents after lower-limb malignant tumour resection and reconstruction using the induced-membrane technique. HYPOTHESIS Weight-bearing resumption 6 weeks after the second stage of the induced-membrane procedure promotes bone healing. MATERIAL AND METHODS The study included 13 patients (9 with osteosarcoma, 3 with Ewing's sarcomas, and 1 with alveolar sarcoma) managed between 2000 and 2020 by oncological femoral or tibial resection followed, at a distance from adjuvant chemotherapy, by reconstruction using the induced-membrane technique. Non-union was the primary outcome measure and the MusculoSkeletal Tumor Society (MSTS) lower-limb functional score was the secondary outcome measure. Mean follow-up was 6.1 years (range, 2.0-12.7). At last follow-up, mean age was 18.1 years (range, 11.0-26.0) and the mean MSTS score was 66.6% (37.0-93.0%). RESULTS After the second reconstruction stage, 8 complications developed in 6 patients (46%). Either a complication or limb-length inequality required 12 re-operations in 8 patients (61.5%). Non-union occurred after reconstruction in 5 (38.5%) patients. Early resumption of 50% weight-bearing 6 weeks after reconstruction was associated with bone healing (p=0.02). CONCLUSION The non-union rate was 38.5%. Partial, 50% weight-bearing with two elbow crutches and an orthosis, if allowed by construct stability, may promote bone healing. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Thibault Marty-Diloy
- Service de chirurgie orthopédique et traumatologique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France
| | - Grégoire Rougereau
- Service de chirurgie orthopédique et traumatologique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France; Service de chirurgie orthopédique et traumatologique, hôpital Pitié Salpêtrière, université de la Sorbonne, AP-HP, 75571 Paris, France
| | - Pierre Mary
- Service de chirurgie orthopédique et traumatologique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France
| | - Raphael Vialle
- Service de chirurgie orthopédique et traumatologique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France; Département hospitalo-universitaire MAMUTH pour les thérapies innovantes dans les maladies musculo-squelettiques, université de la Sorbonne, Paris, France
| | - Franck Fitoussi
- Service de chirurgie orthopédique et traumatologique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France
| | - Raphael Pietton
- Service de chirurgie orthopédique et traumatologique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France; Service de chirurgie orthopédique et traumatologique, hôpital Pitié Salpêtrière, université de la Sorbonne, AP-HP, 75571 Paris, France
| | - Tristan Langlais
- Service de chirurgie orthopédique et traumatologique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France; Département d'orthopédie pédiatrique, hôpital des enfants, Purpan, université de Toulouse, Toulouse, France.
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Rios P, Herlemont P, Fauque P, Lacour B, Jouannet P, Weill A, Zureik M, Clavel J, Dray-Spira R. Medically Assisted Reproduction and Risk of Cancer Among Offspring. JAMA Netw Open 2024; 7:e249429. [PMID: 38696167 PMCID: PMC11066701 DOI: 10.1001/jamanetworkopen.2024.9429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/12/2024] [Indexed: 05/05/2024] Open
Abstract
Importance Cancer is a leading cause of death among children worldwide. Treatments used for medically assisted reproduction (MAR) are suspected risk factors because of their potential for epigenetic disturbance and associated congenital malformations. Objective To assess the risk of cancer, overall and by cancer type, among children born after MAR compared with children conceived naturally. Design, Setting, and Participants For this cohort study, the French National Mother-Child Register (EPI-MERES) was searched for all live births that occurred in France between January 1, 2010, and December 31, 2021 (and followed up until June 30, 2022). The EPI-MERES was built from comprehensive data of the French National Health Data System. Data analysis was performed from December 1, 2021, to June 30, 2023. Exposure Use of assisted reproduction technologies (ART), such as fresh embryo transfer (ET) or frozen ET (FET), and artificial insemination (AI). Main Outcomes and Measures The risk of cancer was compared, overall and by cancer type, among children born after fresh ET, FET, or AI and children conceived naturally, using Cox proportional hazards regression models adjusted for maternal and child characteristics at birth. Results This study included 8 526 306 children with a mean (SD) age of 6.4 (3.4) years; 51.2% were boys, 96.4% were singletons, 12.1% were small for gestational age at birth, and 3.1% had a congenital malformation. There were 260 236 children (3.1%) born after MAR, including 133 965 (1.6%) after fresh ET, 66 165 (0.8%) after FET, and 60 106 (0.7%) after AI. A total of 9256 case patients with cancer were identified over a median follow-up of 6.7 (IQR, 3.7-9.6) years; 165, 57, and 70 were born after fresh ET, FET, and AI, respectively. The overall risk of cancer did not differ between children conceived naturally and those born after fresh ET (hazard ratio [HR], 1.12 [95% CI, 0.96 to 1.31]), FET (HR, 1.02 [95% CI, 0.78 to 1.32]), or AI (HR, 1.09 [95% CI, 0.86 to 1.38]). However, the risk of acute lymphoblastic leukemia was higher among children born after FET (20 case patients; HR 1.61 [95% CI, 1.04 to 2.50]; risk difference [RD], 23.2 [95% CI, 1.5 to 57.0] per million person-years) compared with children conceived naturally. Moreover, among children born between 2010 and 2015, the risk of leukemia was higher among children born after fresh ET (45 case patients; HR, 1.42 [95% CI, 1.06 to 1.92]; adjusted RD, 19.7 [95% CI, 2.8 to 43.2] per million person-years). Conclusions and Relevance The findings of this cohort study suggest that children born after FET or fresh ET had an increased risk of leukemia compared with children conceived naturally. This risk, although resulting in a limited number of cases, needs to be monitored in view of the continuous increase in the use of ART.
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Affiliation(s)
- Paula Rios
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
- Epidemiology of Childhood and Adolescent Cancers, Centre for Research in Epidemiology and Statistics, French National Institute for Health and Medical Research (INSERM) Joint Research Unit (UMR) 1153, Université Paris-Cité, Paris, France
| | - Philippe Herlemont
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Patricia Fauque
- INSERM UMR 1231, Université Bourgogne Franche-Comté, Dijon, France
| | - Brigitte Lacour
- Epidemiology of Childhood and Adolescent Cancers, Centre for Research in Epidemiology and Statistics, French National Institute for Health and Medical Research (INSERM) Joint Research Unit (UMR) 1153, Université Paris-Cité, Paris, France
- French National Registry of Childhood Cancers, Assistance Publique–Hôpitaux de Paris, Centre Hospitalier Régional Universitaire (CHU) Paul Brousse, Villejuif, France
- French National Registry of Childhood Solid Tumours, CHU de Nancy, Nancy, France
| | | | - Alain Weill
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Mahmoud Zureik
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Jacqueline Clavel
- Epidemiology of Childhood and Adolescent Cancers, Centre for Research in Epidemiology and Statistics, French National Institute for Health and Medical Research (INSERM) Joint Research Unit (UMR) 1153, Université Paris-Cité, Paris, France
- French National Registry of Childhood Cancers, Assistance Publique–Hôpitaux de Paris, Centre Hospitalier Régional Universitaire (CHU) Paul Brousse, Villejuif, France
- French National Registry of Childhood Solid Tumours, CHU de Nancy, Nancy, France
| | - Rosemary Dray-Spira
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
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Awounou D, Mancini M, Lacour B, de Crouy-Chanel P, Aerts I, Minard-Colin V, Schleiermacher G, Verschuur A, Guissou S, Desandes E, Guldner L, Clavel J, Goujon S. Residential proximity to vines and risk of childhood embryonal tumours in France - GEOCAP case-control study, 2006-2013. ENVIRONMENTAL RESEARCH 2024; 240:117417. [PMID: 37865323 DOI: 10.1016/j.envres.2023.117417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/29/2023] [Accepted: 10/14/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Exposure to pesticides has been suggested as a potential risk factor for childhood embryonal tumour. The existing literature has mainly focused on parental occupational exposure and domestic use of pesticides, and is very limited for residential exposures to agricultural pesticides. The study aimed to test the hypothesis of an increased risk of embryonal tumour in children living close to viticultural plots, likely to be subject to frequent pesticide applications. METHODS The study is part of the French national registry-based GEOCAP program. We included 2761 cases of neuroblastoma, retinoblastoma, Wilms tumour and rhabdomyosarcoma diagnosed before the age of 15 years in the 2006-2013 period, and 40,196 controls representative of the same age population during this period. Indicators of proximity to vines, the presence of vines and viticulture density within 1000 m of the geocoded addresses of residence, were evaluated combining three sources of data on agricultural land use in a geographic information system. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regressions and carried out several sensitivity analyses to test the stability of the results. RESULTS Approximately 10% of the controls lived within 1000 m of vines, with regional variations ranging from <1% to 38%. We observed a 5% increase in the risk of neuroblastoma for a 10% increase in viticulture density (OR = 1.05, 95% CI: 0.98-1.13), with a regional heterogeneity. The indicators of proximity to vines were not associated with the other non-CNS embryonal tumours. CONCLUSION The study showed a slight increase in the risk of neuroblastoma in children living close to vines, suggesting that residential exposure to agricultural pesticides may be involved in the occurrence of these tumours.
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Affiliation(s)
- Danielle Awounou
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France.
| | - Matthieu Mancini
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Brigitte Lacour
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France; French National Registry of Childhood Cancers, RNHE, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, AP-HP, Villejuif, and RNTSE, CHRU de Nancy, Vandœuvre-lès-Nancy, France
| | - Perrine de Crouy-Chanel
- Santé publique France, the French Public Health Agency, Direction Appui, Traitements et Analyses des données (DATA), Saint-Maurice, France
| | - Isabelle Aerts
- SIREDO Centre (Care, Innovation, Research In Pediatric, Adolescent and Young Adult Oncology), Institut Curie, Paris, France
| | - Véronique Minard-Colin
- Department of Paediatric and Adolescent Oncology, Institut Gustave Roussy - Inserm UMR1015, Université Paris Saclay, Villejuif, France
| | - Gudrun Schleiermacher
- SIREDO Centre (Care, Innovation, Research In Pediatric, Adolescent and Young Adult Oncology), Institut Curie, Paris, France
| | - Arnauld Verschuur
- Department of Paediatric Haematology, Immunology and Oncology, Children Hospital of La Timone, AP-HM, 13385, Marseille, France
| | - Sandra Guissou
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France; French National Registry of Childhood Cancers, RNHE, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, AP-HP, Villejuif, and RNTSE, CHRU de Nancy, Vandœuvre-lès-Nancy, France
| | - Emmanuel Desandes
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France; French National Registry of Childhood Cancers, RNHE, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, AP-HP, Villejuif, and RNTSE, CHRU de Nancy, Vandœuvre-lès-Nancy, France
| | - Laurence Guldner
- Santé publique France, the French Public Health Agency, Direction Santé Environnement Travail (DSET), Saint-Maurice, France
| | - Jacqueline Clavel
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France; French National Registry of Childhood Cancers, RNHE, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, AP-HP, Villejuif, and RNTSE, CHRU de Nancy, Vandœuvre-lès-Nancy, France
| | - Stéphanie Goujon
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France; French National Registry of Childhood Cancers, RNHE, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, AP-HP, Villejuif, and RNTSE, CHRU de Nancy, Vandœuvre-lès-Nancy, France.
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Mrad C, Chamouni A, Guerra X, Tordjman M, Tabone MD, Audry G, Irtan S. Nephrometry Scoring Systems for Nephron Sparing Surgery in Children. J Pediatr Hematol Oncol 2024; 46:1-7. [PMID: 37962119 DOI: 10.1097/mph.0000000000002781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/06/2023] [Indexed: 11/15/2023]
Abstract
The surgical decision to attempt nephron-sparing surgery (NSS) in children with renal tumors can be difficult. In adults, nephrometric tools are used for decision-making. More than 90% of low-complexity tumors are eligible for NSS, and high-complexity tumors often require total nephrectomy. We retrospectively applied those nephrometric tools [Radius, Exophytic, Nearness to the sinus or collecting system, Anterior/posterior, Location relative to polar lines (RENAL), Preoperative Aspects and Dimensions Used for an Anatomical classification (PADUA), and Renal Tumor Invasion Index (RTII) scoring systems] to the preoperative imaging of children operated for renal tumors in our institution from 2015 to 2019 and correlated them with the type of surgery. The scores were assessed by 2 independent surgeons and 1 radiologist. Forty-four tumors were removed, including 16 NSS, 38 after neo-adjuvant chemotherapy, and 6 upfront surgeries, in 30 children. More than 50% of patients in the low and medium-risk population for RENAL, PADUA, and RTII scores, and ~15% in the high-complexity categories underwent NSS. Tumors removed through NSS were significantly less complex according to each score. Interobserver reliability was good for 3 scores. The application of the RENAL, PADUA, and RTII was able to accurately classify most of the pediatric tumors, according to their complexity. These scores could help increase the indications of NSS in renal tumor surgery.
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Affiliation(s)
- Chaima Mrad
- Department of Visceral and Neonatal Pediatric Surgery, Sorbonne University
- Department of Pediatric Onco-Hematology, Armand Trousseau Hospital
| | - Alexandre Chamouni
- Department of Visceral and Neonatal Pediatric Surgery, Sorbonne University
| | - Xavier Guerra
- Department of Radiology, Raymond Poincaré Hospital, Garches-Public Assistance of the Hospitals of Paris, Paris, France
| | - Mickaël Tordjman
- Department of Radiology, Raymond Poincaré Hospital, Garches-Public Assistance of the Hospitals of Paris, Paris, France
| | | | - Georges Audry
- Department of Visceral and Neonatal Pediatric Surgery, Sorbonne University
| | - Sabine Irtan
- Department of Visceral and Neonatal Pediatric Surgery, Sorbonne University
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Campbell K, Siegel DA, Umaretiya PJ, Dai S, Heczey A, Lupo PJ, Schraw JM, Thompson TD, Scheurer ME, Foster JH. A comprehensive analysis of neuroblastoma incidence, survival, and racial and ethnic disparities from 2001 to 2019. Pediatr Blood Cancer 2024; 71:e30732. [PMID: 37867409 PMCID: PMC11018254 DOI: 10.1002/pbc.30732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND We characterize the incidence and 5-year survival of children and adolescents with neuroblastoma stratified by demographic and clinical factors based on the comprehensive data from United States Cancer Statistics (USCS) and the National Program of Cancer Registries (NPCR). METHODS We analyzed the incidence of neuroblastoma from USCS (2003-2019) and survival data from NPCR (2001-2018) for patients less than 20 years old. Incidence trends were calculated by average annual percent change (AAPC) using joinpoint regression. Differences in relative survival were estimated comparing non-overlapping confidence intervals (CI). RESULTS We identified 11,543 primary neuroblastoma cases in USCS. Age-adjusted incidence was 8.3 per million persons [95% CI: 8.2, 8.5], with an AAPC of 0.4% [95% CI: -0.1, 0.9]. Five-year relative survival from the NPCR dataset (n = 10,676) was 79.7% [95% CI: 78.9, 80.5]. Patients aged less than 1 year had the highest 5-year relative survival (92.5%). Five-year relative survival was higher for non-Hispanic White patients (80.7%) or Hispanic patients (80.8%) compared to non-Hispanic Black patients (72.6%). CONCLUSION Neuroblastoma incidence was stable during 2003-2019. Differences in relative survival exist by sex, age, race/ethnicity, and stage; patients who were male, older, non-Hispanic Black, or with distant disease had worse survival. Future studies could seek to assess the upstream factors driving disparities in survival, and evaluate interventions to address inequities and improve survival across all groups.
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Affiliation(s)
- Kevin Campbell
- Division of Hematology-Oncology and Bone Marrow Transplantation, Children’s Mercy Hospitals and Clinics, Kansas City, Missouri, USA
| | - David A. Siegel
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Puja J. Umaretiya
- Division of Hematology-Oncology and Bone Marrow Transplantation, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Shifan Dai
- Cyberdata Technologies, Inc., Herndon, Virginia, USA
| | - Andras Heczey
- Division of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Cancer and Hematology Centers, Texas Children’s Hospital, Houston, Texas, USA
| | - Philip J. Lupo
- Division of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Cancer and Hematology Centers, Texas Children’s Hospital, Houston, Texas, USA
- Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Jeremy M. Schraw
- Division of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Cancer and Hematology Centers, Texas Children’s Hospital, Houston, Texas, USA
- Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Trevor D. Thompson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael E. Scheurer
- Division of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Cancer and Hematology Centers, Texas Children’s Hospital, Houston, Texas, USA
- Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Jennifer H. Foster
- Division of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Cancer and Hematology Centers, Texas Children’s Hospital, Houston, Texas, USA
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Coppin R, Martelli H, Chargari C, Sudour-Bonnange H, Orbach D, Vérité C, Pasquet M, Saumet L, Piguet C, Patte C, Guérin F, Faure-Conter C, Fresneau B. Outcome and late effects of patients treated for childhood vaginal malignant germ cell tumors. Pediatr Blood Cancer 2023; 70:e30697. [PMID: 37798818 DOI: 10.1002/pbc.30697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/31/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE Vaginal malignant germ cell tumors (MGCT) are rare, occurring in children less than 2 years old and raise the question of the optimal local treatment. METHODS We included children treated for vaginal MGCT according to the French TGM-95/2013 regimen. Patients were classified as standard risk (SR: localized disease and alpha-fetoprotein (AFP) < 10,000 ng/mL) or high risk (HiR: metastatic and/or AFP > 10,000 ng/mL) and were treated, respectively, with three to five VBP (vinblastine-bleomycin-cisplatin) or four to six VIP (etoposide-ifosfamide-cisplatin), followed by conservative surgery and/or brachytherapy in case of post-chemotherapy residuum. RESULTS Fourteen patients were included (median age = 12 months), of which six (43%) were classified as HiR. AFP levels were normalized after first-line chemotherapy in all cases but one. A vaginal post-chemotherapy residuum (median size = 8 mm, range: 1-24 mm) was observed in 13/14 patients, treated by complete resection in seven of 13 (viable cells in three of seven), incomplete resection in four of 13 (viable cells in two of four), with adjuvant brachytherapy in two of 13, and exclusive brachytherapy in two of 13 (viable cells in one of six). Among the six patients with viable disease, four patients received adjuvant chemotherapy. One patient (SR) experienced immediate postoperative relapse despite presenting no viable residual cells and was treated with four VIP cycles and brachytherapy. At last follow-up (median = 4.6 years, range: 0.5-16), all patients were alive in complete remission. Five patients suffered from vaginal sequelae with synechiae and/or stenosis (of whom four had undergone brachytherapy). CONCLUSION Childhood vaginal MGCTs show a highly favorable prognosis with risk-adapted chemotherapy and local treatment of post-chemotherapy residuum (preferably by conservative surgery with partial vaginectomy). Brachytherapy could be an alternative when conservative surgery is not deemed possible or in cases of incomplete resection with residual viable cells.
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Affiliation(s)
- Robin Coppin
- Department of Children and Adolescents Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Helene Martelli
- Department of Pediatric Surgery, Bicêtre Hospital - Assistance Publique-Hôpitaux de Paris - Université Paris Saclay, Le Kremlin-Bicêtre, France
| | - Cyrus Chargari
- Department of Radiation Therapy, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | | | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer) Institut Curie, PSL University, Paris, France
| | - Cecile Vérité
- Department of Pediatric Onco-Hematology, Centre Hospitalier Universitaire, Bordeaux, France
| | - Marlene Pasquet
- Department of Pediatric Onco-Hematology, Centre Hospitalier Universitaire, Toulouse, France
| | - Laure Saumet
- Department of Pediatric Onco-Hematology, Centre Hospitalier Universitaire, Montpellier, France
| | - Christophe Piguet
- Department of Pediatric Onco-Hematology, Centre Hospitalier Universitaire, Limoges, France
| | - Catherine Patte
- Department of Children and Adolescents Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Florent Guérin
- Department of Pediatric Surgery, Bicêtre Hospital - Assistance Publique-Hôpitaux de Paris - Université Paris Saclay, Le Kremlin-Bicêtre, France
| | - Cecile Faure-Conter
- Department of Pediatric Oncology, Institut d'Hemato-Oncologie Pediatrique, Lyon, France
| | - Brice Fresneau
- Department of Children and Adolescents Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
- Paris-Saclay University, Paris-Sud University, Epidemiology of Radiation, CESP, INSERM, Villejuif, France
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7
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Feraille A, Liard A, Rives N, Bubenheim M, Barbotin AL, Giscard d'Estaing S, Mirallié S, Ancelle A, Roux C, Brugnon F, Daudin M, Schneider P, Dumont L, Rondanino C. Impact of low- or moderate-risk gonadotoxic chemotherapy prior to testicular tissue freezing on spermatogonia quantity in human (pre)pubertal testicular tissue. Hum Reprod 2023; 38:2105-2118. [PMID: 37674325 DOI: 10.1093/humrep/dead161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 06/20/2023] [Indexed: 09/08/2023] Open
Abstract
STUDY QUESTION What is the impact of low- or moderate-risk gonadotoxic chemotherapy received prior to testicular tissue freezing (TTF), and of the cancer itself, on spermatogonia quantity in testicular tissue from (pre)pubertal boys? SUMMARY ANSWER Vincristine, when associated with alkylating agents, has an additional adverse effect on spermatogonia quantity, while carboplatin has no individual contribution to spermatogonia quantity, in testicular tissue of (pre)pubertal boys, when compared to patients who have received non-alkylating chemotherapy. WHAT IS KNOWN ALREADY The improved survival rates after cancer treatment necessitate the inclusion of fertility preservation procedures as part of the comprehensive care for patients, taking into consideration their age. Sperm cryopreservation is an established procedure in post-pubertal males while the TTF proposed for (pre)pubertal boys remains experimental. Several studies exploring testicular tissue of (pre)pubertal boys after TTF have examined the tubular fertility index (TFI, percentage of seminiferous tubule cross-sections containing spermatogonia) and the number of spermatogonia per seminiferous tubule cross-section (S/T). All studies have demonstrated that TFI and S/T always decrease after the introduction of chemotherapeutic agents, especially those which carry high gonadotoxic risks such as alkylating agents. STUDY DESIGN, SIZE, DURATION Testicular tissue samples from 79 (pre)pubertal boys diagnosed with cancer (from 6 months to 16 years of age) were cryopreserved between May 2009 and June 2014. Their medical diagnoses and previous chemotherapy exposures were recorded. We examined histological sections of (pre)pubertal testicular tissue to elucidate whether the chemotherapy or the primary diagnosis affects mainly TFI and S/T. PARTICIPANTS/MATERIALS, SETTING, METHODS (Pre)pubertal boys with cancer diagnosis who had been offered TTF prior to conditioning treatment for hematopoietic stem cell transplantation were included in the study. All the patients had previously received chemotherapy with low- or moderate-risk for future fertility. We have selected patients for whom the information on the chemotherapy received was complete. The quantity of spermatogonia and quality of testicular tissue were assessed by both morphological and immunohistochemical analyses. MAIN RESULTS AND THE ROLE OF CHANCE A significant reduction in the number of spermatogonia was observed in boys treated with alkylating agents. The mean S/T values in boys exposed to alkylating agents were significantly lower compared to boys exposed to non-alkylating agents (P = 0.018). In contrast, no difference was observed for patients treated with carboplatin as the sole administered alkylating agent compared to the group of patients exposed to non-alkylating agents. We observed an increase of S/T with age in the group of patients who did not receive any alkylating agent and a decrease of S/T with age when patients received alkylating agents included in the cyclophosphamide equivalent dose (CED) formula (r = 0.6166, P = 0.0434; r = -0.3759, P = 0.0036, respectively). The TFI and S/T decreased further in the group of patients who received vincristine in combination with alkylating agents (decrease of 22.4%, P = 0.0049 and P < 0.0001, respectively), but in this group the CED was also increased significantly (P < 0.0001). Multivariate analysis, after CED adjustment, showed the persistence of a decrease in TFI correlated with vincristine administration (P = 0.02). LIMITATIONS, REASONS FOR CAUTION This is a descriptive study of testicular tissues obtained from (pre)pubertal boys who were at risk of infertility. The study population is quite heterogeneous, with a small number of patients in each sub-group. Our results are based on comparisons between patients receiving alkylating agents compared to patients receiving non-alkylating agents rather than chemotherapy-naive patients. The French national guidelines for fertility preservation in cancer patients recommend TTF before highly gonadotoxic treatment. Therefore, all the patients had received low- or moderate-risk gonadotoxic chemotherapy before TTF. Access to testicular tissue samples from chemotherapy-naive patients with comparable histological types of cancer was not possible. The functionality of spermatogonia and somatic cells could not be tested by transplantation or in vitro maturation due to limited sample sizes. WIDER IMPLICATIONS OF THE FINDINGS This study summarizes the spermatogonial quantity of (pre)pubertal boys prior to TTF. We confirmed a negative correlation between the cumulative exposure to alkylating agents and spermatogonial quantity. In addition, the synergistic use of vincristine in combination with alkylating agents showed a cumulative deleterious effect on the TFI. For patients for whom fertility preservation is indicated, TTF should be proposed for chemotherapy with a predicted CED above 4000 mg/m2. However, the data obtained from vincristine and carboplatin use should be confirmed in a subsequent study including more patients. STUDY FUNDING/COMPETING INTEREST(S) This study had financial support from a French national research grant PHRC No. 2008/071/HP obtained by the French Institute of Cancer and the French Healthcare Organization. The sponsors played no role in the study. The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Aurélie Feraille
- Biology of Reproduction-CECOS Laboratory, Univ Rouen Normandie, Inserm U1239, NorDIC, Team "Adrenal and Gonadal Pathophysiology", Rouen University Hospital, Rouen, France
| | - Agnès Liard
- Department of Child Surgery, Univ Rouen Normandie, Rouen University Hospital, Rouen, France
| | - Nathalie Rives
- Biology of Reproduction-CECOS Laboratory, Univ Rouen Normandie, Inserm U1239, NorDIC, Team "Adrenal and Gonadal Pathophysiology", Rouen University Hospital, Rouen, France
| | | | - Anne-Laure Barbotin
- Institut de Biologie de la Reproduction-Spermiologie-CECOS de Lille, CHU de Lille, Lille, France
| | | | - Sophie Mirallié
- Laboratoire de Biologie de la Reproduction-CECOS de Nantes, CHU de Nantes, Nantes, France
| | - Amélie Ancelle
- Laboratoire de Biologie de la Reproduction-CECOS de Caen, CHU de Caen, Caen, France
| | - Christophe Roux
- Laboratoire de Biologie de la Reproduction-CECOS de Besançon, CHU de Besançon, Besançon, France
| | - Florence Brugnon
- Laboratoire de Biologie de la Reproduction-CECOS d'Auvergne, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Myriam Daudin
- CECOS Midi-Pyrénées, University Hospital of Toulouse, Hôpital Paule de Viguier, Toulouse, France
| | - Pascale Schneider
- Department of Pediatric Hematology and Oncology, Univ Rouen Normandie, Rouen University Hospital, Rouen, France
| | - Ludovic Dumont
- Biology of Reproduction-CECOS Laboratory, Univ Rouen Normandie, Inserm U1239, NorDIC, Team "Adrenal and Gonadal Pathophysiology", Rouen University Hospital, Rouen, France
| | - Christine Rondanino
- Biology of Reproduction-CECOS Laboratory, Univ Rouen Normandie, Inserm U1239, NorDIC, Team "Adrenal and Gonadal Pathophysiology", Rouen University Hospital, Rouen, France
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Trallero J, Sanvisens A, Almela Vich F, Jeghalef El Karoni N, Saez Lloret I, Díaz-del-Campo C, Marcos-Navarro AI, Aizpurua Atxega A, Sancho Uriarte P, De-la-Cruz Ortega M, Sánchez MJ, Perucha J, Franch P, Chirlaque MD, Guevara M, Ameijide A, Galceran J, Ramírez C, Camblor MR, Alemán MA, Gutiérrez P, Marcos-Gragera R. Incidence and time trends of childhood hematological neoplasms: a 36-year population-based study in the southern European context, 1983-2018. Front Oncol 2023; 13:1197850. [PMID: 37560466 PMCID: PMC10408119 DOI: 10.3389/fonc.2023.1197850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/07/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Hematological neoplasms (HNs) are the first and most common childhood cancers globally. Currently, there is a lack of updated population-based data on the incidence of these cancers in the Spanish pediatric population. This study aimed to describe the incidence and incidence trends of HNs in children (0-14 years) in Spain using data from the Spanish Network of Cancer Registries and to compare the results with other southern European countries. METHODS Data were extracted from 15 Spanish population-based cancer registries between 1983 and 2018. Cases were coded according to the International Classification of Diseases for Oncology, third edition, first revision, and grouped according to the International Classification of Childhood Cancer, third edition. Crude rates (CRs), age-specific rates, and age-standardized incidence rates using the 2013 European population (ASRE) were calculated and expressed as cases per 1,000,000 child-years. Incidence trends and annual percentage changes (APCs) were estimated. RESULTS A total of 4,747 HNs were recorded (59.5% boys). Age distribution [n (%)] was as follows: <1 year, 266 (5.6%); 1-4 years, 1,726 (36.4%); 5-9 years, 1,442 (30.4%); and 10-14 years, 1,313 (27.6%). Leukemias were the most common group, with a CR and an ASRE of 44.0 (95%CI: 42.5; 45.5) and 44.1 (95%CI: 42.6; 45.7), respectively. The CR and ASRE of lymphomas were 20.1 (95%CI: 19.1; 21.1) and 20.0 (95%CI: 19.0; 21.1), respectively. The comparable incidence rates between our results and those of other southern European countries were similar for lymphomas, while some differences were observed for leukemias. From 1988 to 2016, the trend in leukemia incidence was stable for both sexes, with an APC of 0.0 (95%CI: -0.5; 0.7), whereas a constant overall increase was observed for lymphoma in both sexes, with an APC of 1.0 (95%CI: 0.4; 1.6). CONCLUSION Leukemias are the most common HNs in children, and their incidence has remained stable since 1988, whereas the incidence of lymphomas has increased every year. Lymphoma incidence is like that of other southern European countries, while leukemia incidence is similar only to that of southwestern European countries. Collaborative cancer registry projects allow for assessing epidemiological indicators for cancers such as HNs, which helps health authorities and clinicians provide more knowledge about these malignancies.
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Affiliation(s)
- Jan Trallero
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Girona Biomedical Research Institute Dr. Josep Trueta (IDIBGI), Girona, Spain
- Josep Carreras Leukaemia Research Institute, Badalona, Spain
| | - Arantza Sanvisens
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Girona Biomedical Research Institute Dr. Josep Trueta (IDIBGI), Girona, Spain
- Josep Carreras Leukaemia Research Institute, Badalona, Spain
| | - Fernando Almela Vich
- Registry of Childhood and Adolescent Tumors of the Valencian Community, Valencian Community Department of Universal Health and Public Health, València, Spain
- Cancer Information System of the Valencian Community, Valencian Community Department of Universal Health and Public Health, València, Spain
| | - Noura Jeghalef El Karoni
- Registry of Childhood and Adolescent Tumors of the Valencian Community, Valencian Community Department of Universal Health and Public Health, València, Spain
- Cancer Information System of the Valencian Community, Valencian Community Department of Universal Health and Public Health, València, Spain
| | - Isabel Saez Lloret
- Cancer Information System of the Valencian Community, Valencian Community Department of Universal Health and Public Health, València, Spain
- Castellón Cancer Registry, Directorate General of Public Health and Addictions, Valencian Government, Castellón, Spain
| | | | | | | | | | | | - María José Sánchez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Granada Cancer Registry, Andalusian School of Public Health (EASP), Instituto de Investigación Biosanitaria Ibs. GRANADA, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Josefina Perucha
- La Rioja Cancer Registry, Epidemiology and Health Prevention Service, Logroño, Spain
| | - Paula Franch
- Mallorca Cancer Registry, Public Health and Participation Department, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - María Dolores Chirlaque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Regional Health Authority, Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, Murcia University, Murcia, Spain
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarra Cancer Registry, Navarra Public Health Institute, Pamplona, Spain
- Epidemiology and Public Health Area, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Alberto Ameijide
- Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Sant Joan de Reus University Hospital, Tarragona, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Tarragona, Spain
| | - Jaume Galceran
- Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Sant Joan de Reus University Hospital, Tarragona, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Tarragona, Spain
| | - Cristina Ramírez
- Albacete Cancer Registry, Health and Social Welfare Authority, Albacete, Spain
| | | | - Maria Araceli Alemán
- Canary Islands Cancer Registry, Public Health Directorate, Canary Islands Government, Tenerife, Spain
| | - Pilar Gutiérrez
- Castilla y León Cancer Registry, Public Health Directorate, Castilla y León Government, Valladolid, Spain
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Girona Biomedical Research Institute Dr. Josep Trueta (IDIBGI), Girona, Spain
- Josep Carreras Leukaemia Research Institute, Badalona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Nursing, University of Girona, Girona, Spain
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Shati AA, Khalil MA. Acylated ghrelin suppresses doxorubicin-induced testicular damage and improves sperm parameters in rats via activation of Nrf2 and mammalian target of rapamycin. J Cancer Res Ther 2023; 19:1194-1205. [PMID: 37787283 DOI: 10.4103/jcrt.jcrt_1756_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Background Exogenous administration of acylated ghrelin (AG) afforded reproductive protective effect in several animal models but not in those treated with doxorubicin (DOX). This study evaluated the protective effect of AG against DOX-induced testicular damage and impairment in sperm parameters in rats and examined the potential mechanisms of action. Materials and Methods Adult male rats were divided into five groups (n = 8/each) as control, control + AG (40 nmol/kg/day; subcutaneous), DOX (10 mg/kg/day 1; intraperitoneal [i.p.]), DOX + AG, and DOX + AG + brusatol (an Nrf2 inhibitor) (2 mg/kg/every 3 days; i.p.). The treatment regimen continued for 65 days. Results AG prevented testicular damage and apoptosis; increased sperm count, motility, and viability; and reduced the number of abnormal sperms. It also increased their circulatory levels of AG, des-acylated ghrelin (DAG), and AG/DAG ratio and the testicular mRNA levels of ghrelin and growth hormone secretagogue receptor 1a Concomitantly, AG increased serum and testicular testosterone levels, reduced serum levels of the follicle-stimulating hormone and luteinizing hormone, and upregulated the testicular protein levels of the steroidogenic acute regulatory protein and 3β-hydroxysteroid dehydrogenase in DOX-treated rats. In the testes of the control and DOX-treated rats, AG increased the phosphorylation of mammalian target of rapamycin and stimulated the levels of glutathione and superoxide dismutase, as well as the nuclear activation of Nrf2. All these effects were completely prevented by co-treatment with brusatol. Conclusion AG replacement therapy could be a novel strategy to prevent reproductive toxicity in cancer patients.
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Affiliation(s)
- Ali A Shati
- Department of Biology, College of Science, King Khalid University, Abha, Saudi Arabia
| | - Mohammad A Khalil
- Department of Basic Medical Sciences, Division of Physiology, College of Medicine, King Fahad Medical City, Riyadh, KSA
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10
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Desandes E, Lapouble E, Lacour B, Guissou S, Goujon S, Defachelles AS, Marechal V, Gaspar N, Gomez-Mascard A, Karanian M, Marec-Berard P, Minard-Colin V, Orbach D, Tabone MD, Delattre O, Pierron G. Impact of age on survival according to molecular tumor findings in children and adolescents with soft-tissue and bone sarcoma: The BIOSCA project. Cancer Epidemiol 2023:102398. [PMID: 37357067 DOI: 10.1016/j.canep.2023.102398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Adolescents (15-19 years) with sarcoma are known to have significantly worse survival than children (0-14 years). One possible reason may be that the adolescent sarcomas exhibit specific biological characteristics resulting in differences in clinical presentation and treatment resistance behaviors. The BIOSCA project aims to further explore these age-related differences in survival accounting for molecular tumor characteristic in children and adolescents with sarcoma. METHODS A retrospective national population-based observational study with documented somatic genetic analyses was conducted between 2011 and 2016 of all patients aged from 0 to 17 years with a diagnosis of sarcoma using the National Registry of Childhood Cancers Database. RESULTS A total of 1637 children (0-9years: 40%), preadolescents (10-14years: 35%) and adolescents (15-17 years: 25%) with a diagnosis of bone (N = 845) or soft-tissue (N = 792) sarcoma were included. Adolescents had significantly worse outcome for undifferentiated small round cell sarcoma (USRCS), alveolar rhabdomyosarcoma (ARMS), and epithelioid sarcoma. Five-year overall survivals were worse among CIC-rearranged USRCS cases (47% [95%CI:21-69]) as compared to other USRCS, and PAX3::FOXO1 ARMS patients (44% [95%CI:32-55]) as compared to other ARMS. Adjusting for stage and genomic-profiling status, adolescents with USRCS were 1.6-fold more likely to die than children (P = 0.05), while the difference in survival between age of ARMS patients was weaken. Indeed, the prevalence of PAX3::FOXO1 increased significantly with age. CONCLUSION Age was an independent prognostic factor of outcome only in patients with USRCS, while the association between age and survival of patients with ARMS could be partly explained by differences in prevalence of PAX3::FOXO1.
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Affiliation(s)
- Emmanuel Desandes
- Registre National des cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France; Epidemiology of childhood and adolescent cancers, CRESS, INSERM, UMR1153, Université Paris-Cité, Paris, France.
| | - Eve Lapouble
- Unité de Génétique Somatique, Département de génétique, Institut Curie, Paris, France
| | - Brigitte Lacour
- Registre National des cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France; Epidemiology of childhood and adolescent cancers, CRESS, INSERM, UMR1153, Université Paris-Cité, Paris, France
| | - Sandra Guissou
- Registre National des cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France; Epidemiology of childhood and adolescent cancers, CRESS, INSERM, UMR1153, Université Paris-Cité, Paris, France
| | - Stéphanie Goujon
- Epidemiology of childhood and adolescent cancers, CRESS, INSERM, UMR1153, Université Paris-Cité, Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Anne-Sophie Defachelles
- Department of Pediatric, Adolescents and Young Adults Oncology, Centre Oscar Lambret, Lille, France
| | - Valérie Marechal
- Unité de Génétique Somatique, Département de génétique, Institut Curie, Paris, France
| | - Nathalie Gaspar
- Department of Oncology for Child and Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Anne Gomez-Mascard
- Laboratoire d'anatomie et cytologie pathologiques, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Marie Karanian
- Departments of Biopathology, Centre Léon Bérard, Lyon, France; Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Cancer Research of Lyon, Lyon, France
| | - Perrine Marec-Berard
- Département d'hémato-oncologie pédiatrique, IHOPe/Centre Leon Berard, Lyon, France
| | - Véronique Minard-Colin
- Department of Oncology for Child and Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Daniel Orbach
- SIREDO oncology center (Care, Innovation and Research for Children, Adolescents and young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hemato-Oncology, Armand-Trousseau Sorbonne University Hospital, AP-HP, Paris, France
| | - Olivier Delattre
- Unité de Génétique Somatique, Département de génétique, Institut Curie, Paris, France; INSERM U830, Diversity and Plasticity of Childhood Tumors Lab, PSL Research University, SIREDO Oncology Center, Institut Curie Research Center, Paris, France
| | - Gaelle Pierron
- Unité de Génétique Somatique, Département de génétique, Institut Curie, Paris, France
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Bokun J, Popović-Vuković M, Stanić D, Grujičić D, Pekmezović T, Janić D, Paripović L, Ilić V, Pudrlja Slović M, Sarić M, Mišković I, Nidžović B, Gavrilović N, Milinčić M, Nikitović M. Clinical Profile and Outcome of 806 Pediatric Oncology Patients Treated With Radiotherapy at the Serbian National Cancer Center. J Pediatr Hematol Oncol 2023; 45:116-122. [PMID: 36730662 DOI: 10.1097/mph.0000000000002589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 10/10/2022] [Indexed: 02/04/2023]
Abstract
Radiotherapy plays an important role in the multimodal treatment of childhood cancer. Our objective was to provide an analysis of pediatric oncology patients treated with radiotherapy in a national referral institution in Serbia. A retrospective chart review of children treated with radiotherapy between January 2007 and July 2018 was conducted. Of the 806 patients who were identified, 767 formed the basis of this study. CNS tumors (31.2%) were the most common tumors followed by leukemias (17.3%) and bone tumors (14.3%). The most common indication for radiotherapy was in adjuvant setting (69.1%). Anesthesia or sedation was performed on 115 patients. The 5-year and 10-year overall survival rates were 65.7% and 62.1%, respectively. A significant difference in survival in relation to tumor type was seen. The best survival rates were obtained in patients with retinoblastoma, followed by lymphomas and nephroblastoma, while patients with bone sarcomas had the worst survival. The intent of radiotherapy treatment was also a parameter associated with survival. Patients treated with palliative and definitive intent lived shorter than patients treated with prophylactic and adjuvant intent. Our study showed that good treatment outcomes can be achieved in specialized centers with an experienced team of professionals who are dedicated to pediatric oncology.
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Affiliation(s)
- Jelena Bokun
- University of Belgrade
- Pediatric Radiation Oncology Department
| | | | - Dragana Stanić
- University of Belgrade
- Pediatric Radiation Oncology Department
| | - Danica Grujičić
- University of Belgrade
- Pediatric Oncology Department
- Neuro-Oncology Department, Clinic of Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Tatjana Pekmezović
- University of Belgrade
- Institute of Epidemiology, University of Belgrade, Faculty of Medicine
| | | | | | | | | | - Milan Sarić
- Department of Medical Physics, Institute of Oncology and Radiology of Serbia
| | - Ivana Mišković
- Department of Medical Physics, Institute of Oncology and Radiology of Serbia
| | - Borko Nidžović
- Department of Medical Physics, Institute of Oncology and Radiology of Serbia
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12
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Raze T, Lapouble E, Lacour B, Guissou S, Defachelles AS, Gaspar N, Delattre O, Pierron G, Desandes E. PAX-FOXO1 fusion status in children and adolescents with alveolar rhabdomyosarcoma: Impact on clinical, pathological, and survival features. Pediatr Blood Cancer 2023; 70:e30228. [PMID: 36722003 DOI: 10.1002/pbc.30228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 02/02/2023]
Abstract
BACKGROUND Alveolar rhabdomyosarcoma (ARMS) is an aggressive pediatric cancer and cases with fusion PAX3-FOXO1 and PAX7-FOXO1 seem to have a poor prognosis. The aim is to evaluate whether PAX-FOXO1 alterations influence clinical outcome in childhood and adolescence population with ARMS. PROCEDURE A population-based study was conducted between 2011 and 2016 in patients less than 17 years with a diagnosis of ARMS. Overall survival (OS) depending on fusion status with clinical factors was analyzed. RESULTS Out of 111 ARMS patients recorded in the French National Childhood Cancer Registry during the 2011-2016 period, 61% expressed PAX3-FOXO1, 15% expressed PAX7-FOXO1, 13% were FOXO1 fusion-positive without PAX specification, and 7% were PAX-FOXO1 negative (n = 4 missing data). Compared to patients with PAX7-FOXO1 positive ARMS, those with PAX3-FOXO1 positive tumor were significantly older (10-17 years: 57.4% vs. 29.4%), and had more often a metastatic disease (54.4% vs. 23.5%). Poorer 5-year OS for patients with PAX3-FOXO1 and PAX not specified FOXO1-positive tumor were observed (44.0% [32.0-55.4] and 35.7% [13.1-59.4], respectively). After adjustment for stage at diagnosis, patients with positive tumor for PAX3-FOXO1 were 3.6-fold more likely to die than those with positive tumor for PAX7-FOXO1. CONCLUSION At the population level, PAX3-FOXO1 was associated with a significant higher risk of death compared to PAX7-FOXO1-positive and PAX-FOXO1-negative tumors, and could explain poorer 5-year OS observed in adolescence population diagnosed with ARMS. A continuous risk score derived from the combination of clinical parameters with PAX3-FOXO1 fusion status represents a robust approach to improving current risk-adapted therapy for ARMS.
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Affiliation(s)
- Thomas Raze
- Registre National des cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France
| | - Eve Lapouble
- Département de génétique, Unité de Génétique Somatique, Institut Curie, Paris, France
| | - Brigitte Lacour
- Registre National des cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université Paris-Cité, Paris, France
| | - Sandra Guissou
- Registre National des cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université Paris-Cité, Paris, France
| | | | - Nathalie Gaspar
- Département d'Oncologie Enfants et Adolescents, Centre du Cancer Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Olivier Delattre
- Département de génétique, Unité de Génétique Somatique, Institut Curie, Paris, France
- Diversity and Plasticity of Childhood Tumors Lab, INSERM U830, PSL Research University, SIREDO Oncology Center, Institut Curie Research Center, Paris, France
| | - Gaelle Pierron
- Département de génétique, Unité de Génétique Somatique, Institut Curie, Paris, France
| | - Emmanuel Desandes
- Registre National des cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université Paris-Cité, Paris, France
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13
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Awounou D, Lacour B, Desandes E, Guissou S, Cassoux N, Doz F, Dufour C, Minard-Colin V, Schleiermacher G, Taque S, Verschuur A, Clavel J, Goujon S. Seasonality of main childhood embryonal tumours and rhabdomyosarcoma, France, 2000-2015. Cancer Med 2023; 12:8789-8803. [PMID: 36726302 PMCID: PMC10134357 DOI: 10.1002/cam4.5624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/13/2022] [Accepted: 01/03/2023] [Indexed: 02/03/2023] Open
Abstract
Few studies have investigated the seasonal patterns of embryonal tumours. Based on data from the French National Registry of Childhood Cancers, the present study aimed to investigate seasonal variations in embryonal tumour incidence rates by month of birth and by month of diagnosis. The study included 6635 primary embryonal tumour cases diagnosed before the age of 15 years over the period 2000-2015 in mainland France. Assuming monthly variations in incidence rates were homogeneous over 2000-2015, we used a Poisson regression model to test for overall heterogeneity in standardised incidence ratios (SIRs) by month of birth or diagnosis. The seasonal scan statistic method was used to detect monthly excesses or deficits of embryonal tumour cases over the whole study period. The annual reproducibility of the observed monthly variations was formally tested. An overall heterogeneity in incidence rates by month of birth was observed for rhabdomyosarcoma in boys only. Based on the month of diagnosis, a seasonality was evidenced for unilateral retinoblastoma, with a lower incidence rate in the summer (SIRJul-Aug = 0.68, 95% CI = 0.52-0.87), whilst the incidence rate of rhabdomyosarcoma tended to be lower in August (SIRAug = 0.68, 95% CI = 0.52-0.89). No seasonality was detected for the other embryonal tumour groups by month of birth or month of diagnosis. This study is one of the largest to have investigated the seasonality of childhood embryonal tumours. The study showed a seasonal variation in the incidence rates by month of diagnosis for unilateral retinoblastoma and rhabdomyosarcoma. Our findings are likely to reflect a delay in consultation during the summer months. However, the role of seasonally varying environmental exposures cannot be ruled out.
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Affiliation(s)
- Danielle Awounou
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Université Paris Cité, Paris, France
| | - Brigitte Lacour
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Université Paris Cité, Paris, France.,French National Registry of Childhood Solid Tumours (RNTSE), CHU Nancy, Nancy, France
| | - Emmanuel Desandes
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Université Paris Cité, Paris, France.,French National Registry of Childhood Solid Tumours (RNTSE), CHU Nancy, Nancy, France
| | - Sandra Guissou
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Université Paris Cité, Paris, France.,French National Registry of Childhood Solid Tumours (RNTSE), CHU Nancy, Nancy, France
| | - Nathalie Cassoux
- Université Paris Cité, Paris, France.,Department of Surgical Oncology, Institut Curie, Paris, France
| | - François Doz
- Université Paris Cité, Paris, France.,SIREDO Centre (Care, Innovation, Research In Pediatric, Adolescent and Young Adult Oncology), Institut Curie, Paris, France
| | - Christelle Dufour
- Department of Paediatric and Adolescent Oncology, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Véronique Minard-Colin
- Department of Paediatric and Adolescent Oncology, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France.,Inserm, UMR 1015, Université Paris Saclay, Villejuif, France
| | - Gudrun Schleiermacher
- SIREDO Centre (Care, Innovation, Research In Pediatric, Adolescent and Young Adult Oncology), Institut Curie, Paris, France
| | - Sophie Taque
- Department of Paediatrics, CHU Rennes, Rennes, France
| | - Arnauld Verschuur
- Department of Paediatric Haematology, Immunology and Oncology, Children Hospital of La Timone, APHM, Marseille, France
| | - Jacqueline Clavel
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Université Paris Cité, Paris, France.,French National Registry of Childhood Haematological Malignancies (RNHE), Villejuif, France
| | - Stéphanie Goujon
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Université Paris Cité, Paris, France.,French National Registry of Childhood Haematological Malignancies (RNHE), Villejuif, France
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14
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[End of life in pediatric oncology: Is it time to open the debate?]. Bull Cancer 2023; 110:16-18. [PMID: 36428109 DOI: 10.1016/j.bulcan.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022]
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15
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Mallebranche C, Reguerre Y, Fresneau B, Andre N, Berger C, Briandet C, Castex MP, Defachelles AS, Faure-Conter C, Lejeune J, Klein S, Leverger G, Marie-Cardine A, Oudot C, Freycon C, Proust S, Roumy M, Thebaud E, Verite C, Lacour B, Orbach D. The French FRACTURE database: A way to improve knowledge on management of children with very rare tumors. Pediatr Blood Cancer 2022; 69:e30003. [PMID: 36156381 DOI: 10.1002/pbc.30003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/28/2022] [Accepted: 08/29/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Very rare pediatric tumors (VRTs), defined by an annual incidence ≤2 per million inhabitants, represent a heterogeneous group of cancers. Due to their extremely low incidence, knowledge on these tumors is scant. Since 2012, the French Very Rare Tumors Committee (FRACTURE) database has recorded clinical data about VRTs in France. This study aims: (a) to describe the tumors registered in the FRACTURE database; and (b) to compare these data with those registered in the French National Registry of Childhood Cancer (RNCE). METHODS Data recorded in the FRACTURE database between January 1, 2012 and December 31, 2018 were analyzed. In addition, these data were compared with those of the RNCE database between 2012 and 2015 to evaluate the completeness of the documentation and understand any discrepancies. RESULTS A total of 477 patients with VRTs were registered in the FRACTURE database, representing 97 histological types. Of the 14 most common tumors registered in the RNCE (772 patients), only 19% were also registered in the FRACTURE database. Total 39% of children and adolescent VRTs registered in the RNCE and/or FRACTURE database (323 of a total of 828 patients) were not treated in or linked to a specialized pediatric oncology unit. CONCLUSION VRTs represent many different heterogenous entities, which nevertheless account for 10% of all pediatric cancers diagnosed each year. Sustainability in the collection of these rare tumor cases is therefore important, and a regular systematic collaboration between the FRACTURE database and the RNCE register helps to provide a more exhaustive picture of these VRTs and allow research completeness for some peculiar groups of patients.
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Affiliation(s)
| | - Yves Reguerre
- Pediatric Oncology and Hematology Unit, CHU Saint Denis de la Réunion, Bellepierre, France
| | - Brice Fresneau
- Department of Child and Adolescent Cancer, Gustave Roussy Institute, Villejuif, France
| | - Nicolas Andre
- Pediatric Oncology, La Timone Hospital, Marseille, France
| | - Claire Berger
- Lyon University, Jean Monnet University, INSERM, U1059, Sainbiose, University Hospital, Pediatric Hematology-Oncology Department, Saint-Etienne, France
| | | | | | | | - Cécile Faure-Conter
- Pediatric Oncology, Institute of Pediatric Hematology and Oncology (IHOPe), Lyon, France
| | - Julien Lejeune
- Pediatric Oncology and Hematology, CHRU Tours, Tours, France
| | - Sébastien Klein
- Pediatric Oncology and Hematology, CHU Jean-Minjoz, Besançon, France
| | - Guy Leverger
- Hemato-Immuno-Oncology, Trousseau Hospital, APHP, Paris, France
| | | | | | - Claire Freycon
- Pediatric Onco-Hematology, CHU Grenoble - Hôpital Couple-Enfant, La Tronche, France
| | - Stéphanie Proust
- Pediatric Immuno-Hemato-Oncology Unit, CHU Angers, Angers, France
| | - Marianne Roumy
- Pediatric Clinical Research Platform, CHU Angers, Angers, France
| | - Estelle Thebaud
- Pediatric Immuno-Hemato-Oncology Unit, CHU Nantes, Nantes, France
| | - Cécile Verite
- Pediatric Hematology and Oncology, CHU Bordeaux, Bordeaux, France
| | - Brigitte Lacour
- French National Registry of Childhood Solid Tumors, CHU Nancy, Nancy, France.,Inserm UMR 1153, Centre of Research in Epidemiology and StatisticS (CRESS), Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - Daniel Orbach
- SIREDO Oncology Centre (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
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16
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Zbitou A, Desandes E, Guissou S, Mallebranche C, Lacour B. Thyroid cancers in children and adolescents in France: Incidence, survival and clinical management over the 2000-2018 period. Int J Pediatr Otorhinolaryngol 2022; 162:111325. [PMID: 36195013 DOI: 10.1016/j.ijporl.2022.111325] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/19/2022] [Accepted: 09/16/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Thyroid cancer is the first cause of endocrine malignancy among children. Over the past decades, an increase in the incidence rates (IR) has been observed around the world. Our study aimed to describe epidemiology, therapeutic management and survival rates of children and adolescents with thyroid cancer in France. METHODS A population-based study was conducted between 2000 and 2018 in children and adolescents less than 17 years with a diagnostic of thyroid cancer. RESULTS A total of 774 thyroid cancers were included: 579 papillary (PTC), 83 follicular (FTC), and 111 medullary carcinomas (MTC). PTC are more frequent in females and in adolescents whereas MTC mainly concerned children, mostly with a familial predisposition. Almost all patients underwent thyroidectomy, completed for most patients with PTC and FTC by radioiodine therapy. Cervical dissection was performed more frequently in patients having PTC and MTC compared to those with FTC. Between 2000 and 2018, thyroid cancers IR in children fluctuated between 1.3 and 3.2 per million, without any significant trend. The median follow-up time was 11.3 years in children, and 5.7 years in adolescents. The 5year-OS was greater than 98.5%. CONCLUSIONS Population-based studies are crucial for better understanding and delineation of best management of rare diseases as thyroid cancers in pediatric and adolescent population. Considering the very favorable survival, a stratification should be proposed between cases at low risk and cases at high risk of relapse, in order to consider a strategy of therapeutic de-escalation in the most favorable cases.
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Affiliation(s)
- Asma Zbitou
- Registre National des Cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France
| | - Emmanuel Desandes
- Registre National des Cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France; Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université Paris-Cité, Paris, France.
| | - Sandra Guissou
- Registre National des Cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France; Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université Paris-Cité, Paris, France
| | - Coralie Mallebranche
- Univ Angers, Université de Nantes, Inserm, CNRS, CRCI2NA, SFR ICAT, F-49000, Angers, France; Unité d'Immuno-hémato-oncologie Pédiatrique, CHU Angers, Pediatric Immuno-hemato-oncology Unit, France
| | - Brigitte Lacour
- Registre National des Cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France; Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université Paris-Cité, Paris, France
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17
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Kohler BE, Sandler CX, Baque E, Bradford NK, Trost SG. Therapeutic exercise interventions in pediatric survivors of brain cancer and other solid tumors: A scoping review. Front Pediatr 2022; 10:979292. [PMID: 36210932 PMCID: PMC9535626 DOI: 10.3389/fped.2022.979292] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background Improved survival rates for children with solid tumors presents an ongoing challenge of how to maximize quality of survivorship and effectively manage the short- and long-term complications of disease and treatment. To gain an understanding of the extent and nature of research pertaining to therapeutic exercise interventions and identify knowledge gaps, we conducted a scoping review of exercise training studies conducted in pediatric survivors of brain cancer and other solid tumors. Method A systematic literature search was performed across four electronic databases. Papers were selected for full-text review if they included participants treated for brain cancer or other solid tumors, with at least 50% of participants aged ≤ 21 years, evaluated an exercise intervention ≥2-weeks in duration, and were published in an English, peer-reviewed journal. We included the following quantitative study designs; randomized controlled trials, non-randomized trials, and single-arm pre-test-post-test. Results Of the 7,482 citations identified, 17 papers met the inclusion criteria (presenting findings from eleven studies). Two studies were randomized controlled trials, five studies were non-randomized controlled trials, and four studies were a single-arm pre-test post-test design. Average age of participants ranged from 7.3-15.5 years, and time since diagnosis ranged from 3 to 70 months. Five studies included participants with brain tumors exclusively, three studies included other solid tumors, and three studies included a mixed sample (brain and other solid tumors). A wide range of exercise modalities were employed, including cycle ergometry, resistance training, sport, yoga, and active gaming. The length of the exercise program ranged from 3-40 weeks and frequency from 3-11 sessions per week. Exercise session duration ranged from 15-180 min, with most studies reporting 30-90-min sessions. Adherence ranged from 77 to 100%, with none of the studies reporting adverse events. Studies reported improvements in cardiorespiratory fitness, functional strength, physical activity, and quality of life. Conclusions A small number of mostly low methodological quality studies have examined the effects of therapeutic exercise in pediatric survivors of solid tumors. Although limited, the extant literature supports the feasibility and safety of therapeutic exercise interventions for pediatric survivors of brain cancer and other solid tumors.
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Affiliation(s)
- Brooke E. Kohler
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Carolina X. Sandler
- Sport and Exercise Science, School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
- UNSW Fatigue Research Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Emmah Baque
- School of Health Sciences and Social Work, Griffith University, Nathan, QLD, Australia
| | - Natalie K. Bradford
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Cancer and Palliative Care Outcomes Centre, at Centre for Children's Health Research, Queensland University of Technology, South Brisbane, QLD, Australia
| | - Stewart G. Trost
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
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18
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Childhood cancer risks estimates following CT scans: an update of the French CT cohort study. Eur Radiol 2022; 32:5491-5498. [PMID: 35230516 DOI: 10.1007/s00330-022-08602-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/17/2021] [Accepted: 01/28/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Increased risks of central nervous system (CNS) tumors and leukemia associated with computed tomography (CT) exposure during childhood have been reported in recent epidemiological studies. However, no evidence of increased risks was suggested in a previous analysis of the French CT cohort. This study benefits from an updated cohort with a longer follow-up and a larger sample size of patients. METHODS The patients were followed from the date of their first CT (between 2000 and 2011) until their date of cohort exit defined as the earliest among the following: 31 December 2016, date of death, date of first cancer diagnosis or date of their 18th birthday. Cancer incidence, vital status, cancer predisposing factors (PFs), and additional CT scans were collected via external national databases. Hazard ratios (HRs) associated to cumulative organ doses and sex were estimated from Cox models. RESULTS At the end of follow-up, mean cumulative doses were 27.7 and 10.3 mGy for the brain and the red bone marrow (RBM), respectively. In patients without PFs, an HR per 10 mGy of 1.05 (95% CI: 1.01-1.09) for CNS tumors, 1.17 (95% CI: 1.09-1.26) for leukemia, and 0.96 (95% CI: 0.63-1.45) for lymphoma was estimated. These estimates were not modified by the inclusion of CT scans performed outside the participating hospitals or after the inclusion period. CONCLUSIONS This study shows statistically significant dose-response relationships for CNS tumors and leukemia for patients without PFs. KEY POINTS • Computed tomography is the most important contributor to the collective dose for diagnostic imaging to the French population. • Concerns have been raised about possible cancer risks, particularly after exposure to CT in childhood, due to the greater radiation sensitivity of children and to their longer life expectancy. • Analysis of the updated French CT cohort shows statistically significant dose-response relationships for CNS tumors and leukemia.
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Nazon C, Pierrevelcin M, Willaume T, Lhermitte B, Weingertner N, Marco AD, Bund L, Vincent F, Bierry G, Gomez-Brouchet A, Redini F, Gaspar N, Dontenwill M, Entz-Werle N. Together Intra-Tumor Hypoxia and Macrophagic Immunity Are Driven Worst Outcome in Pediatric High-Grade Osteosarcomas. Cancers (Basel) 2022; 14:cancers14061482. [PMID: 35326631 PMCID: PMC8945994 DOI: 10.3390/cancers14061482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/04/2022] [Indexed: 12/25/2022] Open
Abstract
Simple Summary Radiological and immunohistochemical data were correlated with the outcome in a retrospective monocentric cohort of 30 pediatric osteosarcomas (OTS). A necrotic volume of more than 50 cm3 at diagnosis was significantly linked to a worse overall survival (OS). Regarding immunohistochemical analyses, an overexpression of hypoxic markers, such as HIF-1α and anhydrase carbonic IX (CAIX), was significantly linked to a worse OS, while pS6-RP hyperexpression was correlated with a better survival. We also featured that CD68 positive cells, representative of macrophagic M1 polarization, were mostly associated with HIF-1α and CAIX hyperexpressions and that M2-like polarization, mostly related to CD163 positivity, was correlated to mTor activation. These findings, involving clinical, radiological and biology data, allowed us to hypothesize a dual signature association ready to use routinely in future protocols. Abstract Background: Osteosarcomas (OTS) represent the most common primary bone cancer diagnosed in adolescents and young adults. Despite remarkable advances, there are no objective molecular or imaging markers able to predict an OTS outcome at diagnosis. Focusing on biomarkers contributing broadly to treatment resistance, we examine the interplay between the tumor-associated macrophages and intra-tumor hypoxia. Methods: Radiological and immunohistochemical (IHC) data were correlated with the outcome in a retrospective and monocentric cohort of 30 pediatric OTS. We studied hypoxic (pS6, phospho-mTor, HIF-1α and carbonic anhydrase IX (CAIX)) and macrophagic (CD68 and CD163) biomarkers. Results: The imaging analyses were based on MRI manual volumetric measures on axial post-contrast T1 weighted images, where, for each tumor, we determined the necrotic volume and its ratio to the entire tumor volume. When they were above 50 cm3 and 20%, respectively, they correlated with a worse overall survival (p = 0.0072 and p = 0.0136, respectively) and event-free survival (p = 0.0059 and p = 0.0143, respectively). IHC assessments enable a significant statistical link between HIF-1α/CAIX hyper-expressions, CD68+ cells and a worse outcome, whereas activation of mTor pathway was linked to a better survival rate and CD163+ cells. Conclusions: This study evidenced the links between hypoxia and immunity in OTS, as their poor outcome may be related to a larger necrotic volume on diagnostic MRI and, in biopsies, to a specific IHC profile.
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Affiliation(s)
- Charlotte Nazon
- Pediatric Onco-Hematology Unit, University Hospital of Strasbourg, 1 Avenue Molière, CEDEX, 67098 Strasbourg, France; (C.N.); (F.V.)
| | - Marina Pierrevelcin
- CNRS UMR 7021, Laboratory of Bioimaging and Pathologies, Faculty of Pharmacy, 74 Route du Rhin, 67401 Illkirch, France; (M.P.); (B.L.); (M.D.)
| | - Thibault Willaume
- Radiology Department, University Hospital of Strasbourg, 1 Avenue Molière, CEDEX, 67098 Strasbourg, France; (T.W.); (G.B.)
| | - Benoît Lhermitte
- CNRS UMR 7021, Laboratory of Bioimaging and Pathologies, Faculty of Pharmacy, 74 Route du Rhin, 67401 Illkirch, France; (M.P.); (B.L.); (M.D.)
- Pathology Department, University Hospital of Strasbourg, 1 Avenue Molière, CEDEX, 67098 Strasbourg, France;
| | - Noelle Weingertner
- Pathology Department, University Hospital of Strasbourg, 1 Avenue Molière, CEDEX, 67098 Strasbourg, France;
| | - Antonio Di Marco
- Department of Orthopedic Surgery and Traumatology, University Hospital of Strasbourg, 1 Avenue Molière, CEDEX, 67098 Strasbourg, France;
| | - Laurent Bund
- Department of Pediatric Surgery, University Hospital of Strasbourg, 1 Avenue Molière, CEDEX, 67098 Strasbourg, France;
| | - Florence Vincent
- Pediatric Onco-Hematology Unit, University Hospital of Strasbourg, 1 Avenue Molière, CEDEX, 67098 Strasbourg, France; (C.N.); (F.V.)
| | - Guillaume Bierry
- Radiology Department, University Hospital of Strasbourg, 1 Avenue Molière, CEDEX, 67098 Strasbourg, France; (T.W.); (G.B.)
| | - Anne Gomez-Brouchet
- Department of Pathology, University Hospital of Toulouse, 1 Avenue Irène Joliot Curie, 31100 Toulouse, France;
| | - Françoise Redini
- INSERM UMR1238, PHY-OS, Bone Sarcomas and Remodeling of Calcified Tissues, Nantes University, 44000 Nantes, France;
| | - Nathalie Gaspar
- Department of Oncology for Children and Adolescents, Gustave Roussy, 94805 Villejuif, France;
- INSERM U1015, Gustave Roussy, University of Paris-Saclay, 94805 Villejuif, France
- University of Paris-Saclay, 91400 Orsay, France
| | - Monique Dontenwill
- CNRS UMR 7021, Laboratory of Bioimaging and Pathologies, Faculty of Pharmacy, 74 Route du Rhin, 67401 Illkirch, France; (M.P.); (B.L.); (M.D.)
| | - Natacha Entz-Werle
- Pediatric Onco-Hematology Unit, University Hospital of Strasbourg, 1 Avenue Molière, CEDEX, 67098 Strasbourg, France; (C.N.); (F.V.)
- CNRS UMR 7021, Laboratory of Bioimaging and Pathologies, Faculty of Pharmacy, 74 Route du Rhin, 67401 Illkirch, France; (M.P.); (B.L.); (M.D.)
- Correspondence: ; Tel.: +33-3-88-12-83-96; Fax: +33-3-88-12-80-92
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Mainard N, Sharma D, Fron D, Mezel A, Canavese F, Bonnevalle M, Nectoux E. Porous Ceramic Sternal Prosthesis Implantation in a 13-Year-Old Patient Presenting with Metastatic Ewing's Sarcoma. European J Pediatr Surg Rep 2022; 10:e1-e5. [PMID: 35047327 PMCID: PMC8761061 DOI: 10.1055/s-0041-1740328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022] Open
Abstract
Ewing's sarcoma is the second most frequent primary malignant bone tumor in adolescents and young adults. Locations on the thoracic wall represent up to 20% of primary and secondary locations. We present the case of a 13-year-old patient treated with the use of a radiolucency porous bioceramic prosthesis as a sternal replacement for a wide tumor resection in an oncologic context. Focal radiation therapy was not possible due to the high risk of severe myocardial injuries caused by the sternal location of the tumor. The sternum CERAMIL® (I.CERAM, Limoges, France), in porous alumina (Al
2
O
3
) has already been implanted into adults in sternal replacement during its invasion by a tumor or its infectious destruction. There were no complication concerning the surgery. The last follow-up at 2 years postoperatively reveals a satisfactory clinical situation with any functional thoracic complaint and nor any functional respiratory symptoms. The porous alumina sternal prosthesis offers a reliable alternative for sternal replacement indications for children in an oncologic context.
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Affiliation(s)
- Nicolas Mainard
- Department of Pediatric Surgery, Jeanne de Flandre Hospital, Lille, France
| | - Dyuti Sharma
- Department of Pediatric Surgery, Jeanne de Flandre Hospital, Lille, France.,Université Lille 2 Droit et Santé Faculté de Médecine Henri Warembourg, Lille, Hauts-de-France, France
| | - Damien Fron
- Department of Pediatric Surgery, Jeanne de Flandre Hospital, Lille, France
| | - Aurélie Mezel
- Department of Pediatric Surgery, Jeanne de Flandre Hospital, Lille, France
| | - Federico Canavese
- Department of Pediatric Surgery, Jeanne de Flandre Hospital, Lille, France.,Université Lille 2 Droit et Santé Faculté de Médecine Henri Warembourg, Lille, Hauts-de-France, France
| | - Michel Bonnevalle
- Department of Pediatric Surgery, Reference Center for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille, France
| | - Eric Nectoux
- Department of Pediatric Surgery, Jeanne de Flandre Hospital, Lille, France.,Université Lille 2 Droit et Santé Faculté de Médecine Henri Warembourg, Lille, Hauts-de-France, France
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He YY, Wu XJ, Zhou DH, Yang LH, Mai HR, Wan WQ, Luo XQ, Zheng MC, Zhang JL, Ye ZL, Chen HQ, Chen QW, Long XJ, Sun XF, Liu RY, Li QR, Wu BY, Wang LN, Kong XL, Chen GH, Tang XY, Fang JP, Liao N. A Nomogram for Predicting Event-Free Survival in Childhood Acute Lymphoblastic Leukemia: A Multicenter Retrospective Study. Front Oncol 2022; 12:854798. [PMID: 35425700 PMCID: PMC9002097 DOI: 10.3389/fonc.2022.854798] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/28/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Even though childhood acute lymphoblastic leukemia (ALL) has an encouraging survival rate in recent years, some patients are still at risk of relapse or even death. Therefore, we aimed to construct a nomogram to predict event-free survival (EFS) in patients with ALL. METHOD Children with newly diagnosed ALL between October 2016 and July 2021 from 18 hospitals participating in the South China children's leukemia Group (SCCLG) were recruited and randomly classified into two subsets in a 7:3 ratio (training set, n=1187; validation set, n=506). Least absolute shrinkage and selection operator (LASSO) and multivariate Cox regression analysis were adopted to screen independent prognostic factors. Then, a nomogram can be build based on these prognostic factors to predict 1-, 2-, and 3-year EFS. Concordance index (C-index), area under the curve (AUC), calibration curve, and decision curve analysis (DCA) were used to evaluate the performance and clinical utility of nomogram. RESULT The parameters that predicted EFS were age at diagnosis, white blood cell at diagnosis, immunophenotype, ETV6-RUNX1/TEL-AML1 gene fusion, bone marrow remission at day 15, and minimal residual disease at day 15. The nomogram incorporated the six factors and provided C-index values of 0.811 [95% confidence interval (CI) = 0.792-0.830] and 0.797 (95% CI = 0.769-0.825) in the training and validation set, respectively. The calibration curve and AUC revealed that the nomogram had good ability to predict 1-, 2-, and 3-year EFS. DCA also indicated that our nomogram had good clinical utility. Kaplan-Meier analysis showed that EFS in the different risk groups stratified by the nomogram scores was significant differentiated. CONCLUSION The nomogram for predicting EFS of children with ALL has good performance and clinical utility. The model could help clinical decision-making.
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Affiliation(s)
- Yun-yan He
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiao-jing Wu
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Graduate School, Guangxi Medical University, Nanning, China
| | - Dun-hua Zhou
- Children’s Medical Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Li-hua Yang
- Department of Pediatrics, Southern Medical University Zhujiang Hospital, Guangzhou, China
| | - Hui-rong Mai
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Wu-qing Wan
- Department of Pediatrics, Second Xiangya Hospital of Central South University, Changsha, China
| | - Xue-qun Luo
- Department of Pediatrics, Sun Yat-Sen University First Affiliated Hospital, Guangzhou, China
| | - Min-cui Zheng
- Department of Hematology, Hunan Children’s Hospital, Changsha, China
| | - Jun-lin Zhang
- Graduate School, Guangxi Medical University, Nanning, China
| | - Zhong-lv Ye
- Department of Pediatrics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Hui-qin Chen
- Department of Pediatrics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Qi-wen Chen
- Department of Pediatrics, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xing-jiang Long
- Department of Pediatrics, Liuzhou People’s Hospital, Liuzhou, China
| | - Xiao-fei Sun
- Department of Pediatrics, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Ri-yang Liu
- Department of Pediatrics, Huizhou Central People’s Hospital, Huizhou, China
| | - Qiao-ru Li
- Department of Pediatrics, Zhongshan People’s Hospital, Zhongshan, China
| | - Bei-yan Wu
- Department of Pediatrics, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Li-na Wang
- Department of Pediatrics, Guangzhou First People’s Hospital, Guangzhou, China
| | - Xian-ling Kong
- Department of Pediatrics, Boai Hospital of Zhongshan, Zhongshan, China
| | - Guo-hua Chen
- Department of Pediatrics, Huizhou First People’s Hospital, Huizhou, China
| | - Xian-yan Tang
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Jian-pei Fang
- Children’s Medical Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- *Correspondence: Ning Liao, ; Jian-pei Fang,
| | - Ning Liao
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- *Correspondence: Ning Liao, ; Jian-pei Fang,
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Enault M, Minard-Colin V, Corradini N, Leverger G, Thebaud E, Rome A, Proust S, Marie-Cardine A, Defachelles AS, Sarnacki S, Philippe-Chomette P, Delattre O, Masliah-Planchon J, Lacour B, Ferrari A, Brennan B, Orbach D, Bourdeaut F. Extracranial rhabdoid tumours: Results of a SFCE series of patients treated with a dose compression strategy according to European Paediatric Soft tisue sarcoma Study Group recommendations. Eur J Cancer 2022; 161:64-78. [DOI: 10.1016/j.ejca.2021.10.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/30/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022]
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Childhood head and neck cancer in France: Incidence, survival and trends from 2000 to 2015. Int J Pediatr Otorhinolaryngol 2021; 150:110858. [PMID: 34388659 DOI: 10.1016/j.ijporl.2021.110858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Childhood head and neck cancers (HNC) are rare and represent a complex group of anatomical topographies. The aim of this study is to describe the distribution, the incidence and survival rates of children with malignant HNC in France. METHODS A population-based study was conducted between 2000 and 2015 in children less than 15 years with a diagnosis of HNC using the French National Registry of Childhood Cancers database (RNCE). Age-standardized incidence rates (ASR) and survival analysis were performed. RESULTS The 1623 included HNC represented 5.6% of all cancers included in the RNCE. The thyroid was the leading tumor site category (26.6%), followed by head and neck soft tissue location (15.4%) and the nasopharynx (10.8%). The most common cancers were thyroid gland carcinomas (26.1%), rhabdomyosarcomas (23.9%) and Burkitt Lymphomas (8.6%). Nasopharynx cancers and soft-tissue sarcomas were statistically more frequent in boys, while thyroid carcinomas were significantly more frequent in girls. The annual ASR was 8.6 new cancer cases per million children. For all HNC combined, the 5-year overall survival (OS) was 87.7% [95%CI: 85.9-89.2]. There was no statistically significant variation in 5-year OS between 2000-2007 and 2008-2015. CONCLUSIONS Epidemiological data on HNC distribution, incidence and survival contributes to better understand these tumors by quantifying their impact on the French population and assessing their burden. Regarding the exclusion of topographies and some histological origins performed by some authors, this report proposes new recommendations to study HNC in a pediatric population.
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24
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Fitoussi R, Stolowy N, Levy C, Beylerian M, Comet A, Lesueur A, Denis D. [Retinoblastoma with misleading initial presentation in a 7-year-old child]. J Fr Ophtalmol 2021; 45:e107-e109. [PMID: 34373130 DOI: 10.1016/j.jfo.2021.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/21/2021] [Accepted: 03/22/2021] [Indexed: 11/17/2022]
Affiliation(s)
- R Fitoussi
- Service d'ophtalmologie, CHU de Timone, 264, rue Saint-Pierre, 13005 Marseille, France.
| | - N Stolowy
- Service d'ophtalmologie, CHU de Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - C Levy
- Service d'ophtalmologie, CHU de Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - M Beylerian
- Service d'ophtalmologie, CHU de Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - A Comet
- Service d'ophtalmologie, CHU de Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - A Lesueur
- Service d'ophtalmologie, CHU de Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - D Denis
- Service d'ophtalmologie, CHU de Timone, 264, rue Saint-Pierre, 13005 Marseille, France
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Abalo KD, Malekzadeh-Milani S, Hascoët S, Dreuil S, Feuillet T, Cohen S, Dauphin C, Filippo SD, Douchin S, Godart F, Guérin P, Helms P, Karsenty C, Lefort B, Mauran P, Ovaert C, Piéchaud JF, Thambo JB, Leuraud K, Bonnet D, Bernier MO, Rage E. Exposure to low-dose ionising radiation from cardiac catheterisation and risk of cancer: the COCCINELLE study cohort profile. BMJ Open 2021; 11:e048576. [PMID: 34344681 PMCID: PMC8336117 DOI: 10.1136/bmjopen-2020-048576] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The COCCINELLE study is a nationwide retrospective French cohort set up to evaluate the risk of cancer in patients who undergone cardiac catheterisation (CC) procedures for diagnosis or treatment of congenital heart disease during childhood. PARTICIPANTS Children who undergone CC procedures from 1 January 2000 to 31 December 2013, before the age of 16 in one of the 15 paediatric cardiology departments which perform paediatric CC in mainland France were included. The follow-up started at the date of the first recorded CC procedure until the exit date, that is, the date of death, the date of first cancer diagnosis, the date of the 18th birthday or the 31 December 2015, whichever occurred first. The cohort was linked to the National Childhood Cancer Registry to identify patients diagnosed with cancer and with the French National Directory for the Identification of Natural Persons to retrieve the patients' vital status. FINDINGS TO DATE A total of 17 104 children were included in the cohort and followed for 110 335 person-years, with 22 227 CC procedures collected. Among the patients, 81.6% received only one procedure. Fifty-nine cancer cases were observed in the cohort. Standardised incidence ratios (SIRs) were increased for all-cancer (SIR=3.8, 95% CI: 2.9 to 4.9), leukaemia (SIR=3.3, 95% CI: 2.0 to 5.4), lymphoma (SIR=14.9, 95% CI: 9.9 to 22.5) and solid cancers excluding central nervous system (CNS) tumours (SIR=3.3, 95% CI: 2.0 to 5.5) compared with the general population. FUTURE PLANS Dose reconstruction is currently underway to estimate individual cumulative doses absorbed to relevant organs, including red bone marrow and brain for respectively haematologic disorders and CNS tumours risk estimation. A dose-response analysis will be conducted with consideration to confounding factors such as age at exposure, gender, predisposing factors to cancer and other sources of medical diagnostic low-dose ionising radiation.
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Affiliation(s)
- Kossi Dovene Abalo
- PSE-SANTE/SESANE/Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
| | - Sophie Malekzadeh-Milani
- Department of Congenital and Pediatric Cardiology, Necker-Sick Children University Hospital, M3C-Necker, Université de Paris, Paris, France
| | - Sébastien Hascoët
- Paediatric and Congenital Cardiac Surgery Department, M3C Marie-Lannelongue Hospital, National Reference Centre, Groupe Hospitalier Saint-Joseph, Paris Saclay University, Plessis-Robinson, France
| | - Serge Dreuil
- PSE-SANTE/SER/UEM, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
| | | | - Sarah Cohen
- Paediatric and Congenital Cardiac Surgery Department, M3C Marie-Lannelongue Hospital, National Reference Centre, Groupe Hospitalier Saint-Joseph, Paris Saclay University, Plessis-Robinson, France
| | - Claire Dauphin
- Cardiology and Vascular Department, Hopital Gabriel Montpied, Clermont-Ferrand, France
| | - Sylvie Di Filippo
- Paediatric and Congential Cardiology Department, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Stéphanie Douchin
- Cardiopédiatrie, Hôpital couple enfant, CHU Grenoble Alpes, Grenoble cedex 9, France, Grenoble, France
| | - François Godart
- Service de Cardiologie Infantile et Congénitale, Institut Cœur Poumon, Lille Cedex, Lille, France
| | - Patrice Guérin
- Clinique Cardiologique et des Maladies Vasculaires, CIC 1413, Institut du Thorax, Cardiopédiatrie, CHU Nantes, INSERM, Nantes Université, Nantes, France
| | - Pauline Helms
- Unit of Cardiopediatrics, University Hospital of Strasbourg, Strasbourg, France
| | - Clement Karsenty
- Pediatric and Congenital Cardiology, Children's Hospital and INSERM U1048, I2MC, Institut des Maladies Métaboliques et Cardiovasculaires, Université de Toulouse, Toulouse, France
| | - Bruno Lefort
- Institut des Cardiopathies Congénitales, CHRU Tours, Tours, France
| | - Pierre Mauran
- Unité de cardiologie pédiatrique et congénitale, American Memorial Hospital, CHU de Reims, 47 rue Cognacq-Jay, Reims Cedex, Reims, France
| | - Caroline Ovaert
- Cardiologie pédiatrique et congénitale, Timone enfants, AP-HM et INSERM 1251, Aix-Marseille Université, Marseille, France
| | - Jean-François Piéchaud
- Institut Cardiovasculaire Paris Sud, Institut Hospitalier Jacques-Cartier, Massy, France
| | - Jean-Benoît Thambo
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Bordeaux, France
| | - Klervi Leuraud
- PSE-SANTE/SESANE/Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
| | - Damien Bonnet
- Department of Congenital and Pediatric Cardiology, Necker-Sick Children University Hospital, M3C-Necker, Université de Paris, Paris, France
| | - Marie-Odile Bernier
- PSE-SANTE/SESANE/Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
| | - Estelle Rage
- PSE-SANTE/SESANE/Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
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Poulalhon C, Goujon S, Marquant F, Faure L, Guissou S, Bonaventure A, Désandes E, Rios P, Lacour B, Clavel J. Factors associated with 5- and 10-year survival among a recent cohort of childhood cancer survivors (France, 2000-2015). Cancer Epidemiol 2021; 73:101950. [PMID: 34214767 DOI: 10.1016/j.canep.2021.101950] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/28/2021] [Accepted: 05/02/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Childhood cancer survival currently exceeds 80 % five years after diagnosis in high-income countries. In this study, we aimed to describe long-term trends and to investigate socioeconomic and spatial disparities in childhood cancer survival. METHODS The study included 28,073 cases recorded in the French National Registry of Childhood Cancers from 2000 to 2015. Contextual census data (deprivation indices, population density, spatial accessibility to general practitioners) were allocated to each case based on the residence at diagnosis. Overall survival (OS) and conditional 10-year OS for 5-year survivors were estimated for all cancers combined and by diagnostic group and subgroup. Comparisons were conducted by sex, age at diagnosis, period of diagnosis, and contextual indicators. Hazard ratios for death were estimated using Cox models. RESULTS All cancers combined, the OS reached 82.8 % [95 % CI: 82.4-83.3] at 5 years and 80.8 % [95 % CI: 80.3-81.3] at 10 years. Conditional 10-year OS of 5-year survivors reached 97.5 % [95 % CI: 97.3-97.7] and was higher than 95 % for all subgroups except osteosarcomas and most subgroups of the central nervous system. In addition to disparities by sex, age at diagnosis, and period of diagnosis, we observed a slight decrease in survival for cases living in the most deprived areas at diagnosis, not consistent across diagnostic groups. CONCLUSION Our results confirm the high 5-year survival for childhood cancer and show an excellent 10-year conditional survival of 5-year survivors. Additional individual data are needed to clarify the factors underlying the slight decrease in childhood cancer survival observed in the most deprived areas.
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Affiliation(s)
- Claire Poulalhon
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France.
| | - Stéphanie Goujon
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Fabienne Marquant
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Laure Faure
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Sandra Guissou
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Audrey Bonaventure
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France
| | - Emmanuel Désandes
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Paula Rios
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France
| | - Brigitte Lacour
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Jacqueline Clavel
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
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Bamouni S, Hémon D, Faure L, Clavel J, Goujon S. Seasonal variations in childhood leukaemia incidence in France, 1990-2014. Cancer Causes Control 2021; 32:693-704. [PMID: 33829352 DOI: 10.1007/s10552-021-01421-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 03/22/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Several studies have addressed the potential seasonality of childhood acute leukaemia (AL) without conclusive results. Using data from the National Registry of Childhood Cancers over 1990-2014 in mainland France, we investigated the seasonal variations in childhood AL taken together, and lymphoblastic (ALL) and myeloid (AML) leukaemia separately. METHODS Assuming constant variations over 1990-2014, we used a Poisson regression model to evaluate variations in standardized incidence ratios (SIRs) by month of birth or diagnosis. A scan method for temporal cluster detection was used to identify windows of several consecutive months with high or low SIR. The yearly reproducibility of the observed monthly variations was then evaluated. RESULTS We included 11,528 AL, of which 9493 ALL and 1,843 AML. No seasonal variation was detected for ALL. With a clear seasonal pattern, differences in AML incidence rates were evidenced between January-April and May-December birth periods (SIR = 0.85, 95% CI 0.77-0.94 and SIR = 1.07, 95% CI 1.01-1.14, respectively). AML incidence variations by month of diagnosis were less clear-cut. CONCLUSION Based on a large number of cases from a high-quality registry, we did not evidence any seasonality in ALL incidence rates but evidenced seasonal variations in AML incidence rates by month of birth.
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Affiliation(s)
- Sophie Bamouni
- Inserm, UMR 1153 Center of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers team (EPICEA), 16 Avenue Paul Vaillant Couturier - Bat 15/16, 94807, Villejuif Cedex, France. .,Université de Paris, Paris, France.
| | - Denis Hémon
- Inserm, UMR 1153 Center of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers team (EPICEA), 16 Avenue Paul Vaillant Couturier - Bat 15/16, 94807, Villejuif Cedex, France.,Université de Paris, Paris, France
| | - Laure Faure
- Inserm, UMR 1153 Center of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers team (EPICEA), 16 Avenue Paul Vaillant Couturier - Bat 15/16, 94807, Villejuif Cedex, France.,Université de Paris, Paris, France.,French National Registry of Childhood Hematological Malignancies (RNHE), 94807, Villejuif, France
| | - Jacqueline Clavel
- Inserm, UMR 1153 Center of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers team (EPICEA), 16 Avenue Paul Vaillant Couturier - Bat 15/16, 94807, Villejuif Cedex, France.,Université de Paris, Paris, France.,French National Registry of Childhood Hematological Malignancies (RNHE), 94807, Villejuif, France
| | - Stéphanie Goujon
- Inserm, UMR 1153 Center of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers team (EPICEA), 16 Avenue Paul Vaillant Couturier - Bat 15/16, 94807, Villejuif Cedex, France.,Université de Paris, Paris, France.,French National Registry of Childhood Hematological Malignancies (RNHE), 94807, Villejuif, France
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Long-term follow-up of high-risk neuroblastoma survivors treated with high-dose chemotherapy and stem cell transplantation rescue. Bone Marrow Transplant 2021; 56:1984-1997. [PMID: 33824435 DOI: 10.1038/s41409-021-01258-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 02/08/2021] [Accepted: 02/23/2021] [Indexed: 11/08/2022]
Abstract
Intensive treatments including high-dose chemotherapy (HDC) with autologous stem cell rescue have improved high-risk neuroblastoma (HRNB) survival. We report the long-term health status of 145 HRNB survivors, alive and disease-free 5 years post HDC. Median follow-up was 15 years (range = 5-34). Six patients experienced late relapses, 11 developed second malignant neoplasms (SMNs), and 9 died. Event-free and overall survivals 20 years post HDC were 82% (95% CI = 70%-90%) and 89% (78%-95%), respectively. Compared with the French general population, the standardized mortality ratio was 19 (95% CI = 8.7-36.1; p < 0.0001) and the absolute excess risk was 37.6 (19.2-73.5). Late effects were observed in 135/145 patients (median = 3 events/patient); 103 had at least one severe event. SMNs arose at a median of 20 years post HDC and included carcinoma (n = 5), sarcoma (2), acute myeloid leukemia (2), melanoma (1), and malignant glioma (1). Non-oncologic health events included dental maldevelopment (60%), severe hearing loss (20% cumulative probability at 15 years), hepatic focal nodular hyperplasia (14%), thyroid (11%), cardiac (8%), and renal (7%) diseases and growth retardation (height-for-age z-score ≤ -2 for 21%). Gonadal insufficiency was near-universal after busulfan (40/43 females, 33/35 males). Severe late effects are frequent and progressive in HRNB survivors needing systematic very long-term follow-up.
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Berger C, Casagranda L, Sudour-Bonnange H, Massoubre C, Dalle JH, Teinturier C, Martin-Beuzart S, Guillot P, Lanlo V, Schneider M, Dal Molin B, Dal Molin M, Mounier O, Garcin A, Fresneau B, Clavel J, Demoor-Goldschmidt C. Personalized Massive Open Online Course for Childhood Cancer Survivors: Behind the Scenes. Appl Clin Inform 2021; 12:237-244. [PMID: 33763845 DOI: 10.1055/s-0041-1725185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Today, in France, it is estimated that 1 in 850 people aged between 20 and 45 years has been treated for childhood cancer, which equals 40,000 to 50,000 people. As late effects of the cancer and its treatment affect a large number of childhood cancer survivors (CCS) and only 30% of them benefit from an efficient long-term follow-up care for prevention, early detection, and treatment of late effects, health education of CCS represents a challenge of public health. OBJECTIVES Massive open online courses (MOOCs) are a recent innovative addition to the online learning landscape. This entertaining and practical tool could easily allow a deployment at a national level and make reliable information available for all the CCS in the country, wherever they live. METHODS The MOOC team brings together a large range of specialists involved in the long-term follow-up care, but also associations of CCS, video producers, a communication consultant, a pedagogical designer, a cartoonist and a musician. We have designed three modules addressing transversal issues (lifestyle, importance of psychological support, risks of fertility problems) and eight modules covering organ-specific problems. Detailed data on childhood cancer treatments received were used to allocate the specific modules to each participant. RESULTS This paper presents the design of the MOOC entitled "Childhood Cancer, Living Well, After," and how its feasibility and its impact on CCS knowledge will be measured. The MOOC about long-term follow-up after childhood cancer, divided into 11 modules, involved 130 participants in its process, and resulted in a 170-minute film. The feasibility study included 98 CCS (31 males vs. 67 females; p < 0.0001). CONCLUSION Such personalized, free, and online courses with an online forum and a possible psychologist consultation based on unique characteristics and needs of each survivor population could improve adherence to long-term follow-up without alarming them unnecessarily.
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Affiliation(s)
- Claire Berger
- Department of Pediatric Hematology and Oncology, University-Hospital, Saint-Etienne, France.,UMR-S1153, Inserm, Paris Descartes University, Paris, France
| | - Léonie Casagranda
- Department of Pediatric Hematology and Oncology, University-Hospital, Saint-Etienne, France.,Host Research Team EA4607 SNA-EPIS, Jean Monnet University of Saint-Etienne, PRES Lyon, Saint-Etienne, France
| | | | - Catherine Massoubre
- Department of Psychiatry, University-Hospital of Saint-Etienne, Saint-Etienne, France
| | - Jean-Hugues Dalle
- Department of Immunology and Hematology, Robert Debré Hospital, GH APHP-Nord Université de Paris, France
| | - Cecile Teinturier
- Department of Pediatric Endocrinology and diebetology, Bicêtre Hospital, Paris Sud University - Kremlin Bicêtre, France.,Inserm U 1018, CESP, Cancer and Radiation Team, University of Paris-Saclay, Paris-Sud University, Villejuif, France
| | | | - Pascale Guillot
- Department of Rhumatology, University Hospital Nantes, Nantes, France
| | - Virginie Lanlo
- Consultant, Communication and Pedagogical Designer Specialized in MOOC, Pantin, France
| | | | | | | | - Olivier Mounier
- Department of Informatics, University Jean Monnet, Saint-Etienne, France
| | - Arnauld Garcin
- Host Research Team EA4607 SNA-EPIS, Jean Monnet University of Saint-Etienne, PRES Lyon, Saint-Etienne, France.,Department of Research, University Hospital, Saint-Etienne, Cedex, France
| | - Brice Fresneau
- Inserm U 1018, CESP, Cancer and Radiation Team, University of Paris-Saclay, Paris-Sud University, Villejuif, France.,Department of Pediatric Oncology, Gustave Roussy, University of Paris-Saclay, Villejuif, France
| | | | - Charlotte Demoor-Goldschmidt
- Inserm U 1018, CESP, Cancer and Radiation Team, University of Paris-Saclay, Paris-Sud University, Villejuif, France.,Department of Pediatric Hematology and Oncology, University-Hospital of Angers, Angers, France
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Piñeros M, Mery L, Soerjomataram I, Bray F, Steliarova-Foucher E. Scaling Up the Surveillance of Childhood Cancer: A Global Roadmap. J Natl Cancer Inst 2021; 113:9-15. [PMID: 32433739 PMCID: PMC7781445 DOI: 10.1093/jnci/djaa069] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/20/2020] [Accepted: 05/12/2020] [Indexed: 12/12/2022] Open
Abstract
The World Health Organization recently launched the Global Initiative for Childhood Cancer aiming to substantially increase survival among children with cancer by 2030. The ultimate goal concerns particularly less developed countries where survival estimates are considerably lower than in high-income countries where children with cancer attain approximately 80% survival. Given the vast gap in high-quality data availability between more and less developed countries, measuring the success of the Global Initiative for Childhood Cancer will also require substantial support to childhood cancer registries to enable them to provide survival data at the population level. Based on our experience acquired at the International Agency for Research on Cancer in global cancer surveillance, we hereby review crucial aspects to consider in the development of childhood cancer registration and present our vision on how the Global Initiative for Cancer Registry Development can accelerate the measurement of the outcome of children with cancer.
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Affiliation(s)
- Marion Piñeros
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Les Mery
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Eva Steliarova-Foucher
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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Romano E, Simon R, Minard-Colin V, Martin V, Bockel S, Espenel S, Fresneau B, Metayer L, Levy A, Guerin F, Martelli H, Dumas I, Bolle S, Deutsch E, Haie-Meder C, Chargari C. Analysis of Radiation Dose/Volume Effect Relationship for Anorectal Morbidity in Children Treated for Pelvic Malignancies. Int J Radiat Oncol Biol Phys 2021; 109:231-241. [PMID: 32805302 DOI: 10.1016/j.ijrobp.2020.08.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 01/14/2023]
Abstract
PURPOSE To examine dose-volume effect relationships for anorectal morbidity in children treated with image-guided brachytherapy for pelvic tumors. METHODS AND MATERIALS Medical records of all consecutive children with pelvic tumors treated in our center and receiving image-guided pulsed-dose-rate brachytherapy with or without external beam radiation therapy (EBRT) between 2005 and 2019 were reviewed. The effect of the minimal doses to the most exposed 0.5 cm3, 1 cm3, and 2 cm3 of the anorectum (respectively: D0.5cm3, D1cm3, and D2cm3), total reference air kerma (TRAK), and volume of 100% isodose was examined for anorectal toxicities. RESULTS Seventy-eight consecutive children were included. Median age was 2.9 years (range, 0.8-14.9 years). Most of the tumors were bladder or prostate (67%) or vaginal (22%) rhabdomyosarcoma. Six patients received EBRT in addition to brachytherapy. Median follow-up was 21.3 months. At last follow-up, 30 children (38%) had experienced Common Terminology Criteria for Adverse Events version 5 grade ≥1 acute or late anorectal events: 24% had grade 1 events, 7.7% had grade 2 events, and 6.4% had grade 3 events. No toxicity greater than grade 3 was observed (eg, fistula or stricture). In univariate analysis, the D0.5cm3 and D1cm3 were significant for probability of grade 1 to 3 (P = .009 and P = .017, respectively) and grade 2 to 3 anorectal morbidity (P = .007 and P = .049, respectively). There was no significant correlation for D2cm3 (P = .057 for grade 1-3; P = .407 for grade 2-3). A 10% probability (95% confidence interval, 4%-20%) for anorectal toxicity of grade 2 or greater was reached for a D0.5cm3 = 52 Gy. The age, EBRT use, TRAK, and treated volume values were not significant. CONCLUSIONS To our knowledge, this study is the first to show a significant dose-volume effect relationships for anorectal morbidity in children undergoing treatment with brachytherapy. Integrating these data into brachytherapy treatment planning could help to optimize the therapeutic index in these young patients.
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Affiliation(s)
- Edouard Romano
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Cancer Center, University Paris Saclay Medical Faculty, Villejuif, France
| | - Raphaël Simon
- Hospices Civils de Lyon, Lyon Est University Medical Faculty, Lyon, France
| | - Véronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Valentine Martin
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Cancer Center, University Paris Saclay Medical Faculty, Villejuif, France
| | - Sophie Bockel
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Cancer Center, University Paris Saclay Medical Faculty, Villejuif, France
| | - Sophie Espenel
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Cancer Center, University Paris Saclay Medical Faculty, Villejuif, France
| | - Brice Fresneau
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Lucy Metayer
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Antonin Levy
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Cancer Center, University Paris Saclay Medical Faculty, Villejuif, France; INSERM 1030 Molecular radiotherapy, Gustave Roussy Cancer Campus, Villejuif, France
| | - Florent Guerin
- Department of Pediatric Surgery, Kremlin Bicetre University Hospital, Kremlin Bicêtre, France
| | - Hélène Martelli
- Department of Pediatric Surgery, Kremlin Bicetre University Hospital, Kremlin Bicêtre, France
| | - Isabelle Dumas
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Cancer Center, University Paris Saclay Medical Faculty, Villejuif, France
| | - Stéphanie Bolle
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Cancer Center, University Paris Saclay Medical Faculty, Villejuif, France
| | - Eric Deutsch
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Cancer Center, University Paris Saclay Medical Faculty, Villejuif, France; INSERM 1030 Molecular radiotherapy, Gustave Roussy Cancer Campus, Villejuif, France
| | - Christine Haie-Meder
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Cancer Center, University Paris Saclay Medical Faculty, Villejuif, France
| | - Cyrus Chargari
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Cancer Center, University Paris Saclay Medical Faculty, Villejuif, France; INSERM 1030 Molecular radiotherapy, Gustave Roussy Cancer Campus, Villejuif, France; French Military Health Academy, Ecole du Val-de-Grâce, Paris, France; Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, France.
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Mrad C, Coulomb-Lhermine A, Tabone MD, Ulinski T, Audry G, Irtan S. Evaluation of the nephron-sparing surgery formula in Wilms tumors. Pediatr Blood Cancer 2020; 67:e28661. [PMID: 32808461 DOI: 10.1002/pbc.28661] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/16/2020] [Accepted: 07/30/2020] [Indexed: 01/30/2023]
Abstract
AIM Definitions of nephron-sparing surgery (NSS) procedures in Wilms tumor (WT) are not clear. The new UMBRELLA protocol offers a formula (NSS(X)-SRM(n)-PRM(n)-RRP(n%)) to better define the different NSS parameters. We aimed to assess the advantages and limits of this new formula. METHODS This retrospective monocentric study included patients operated by NSS for WT from 1975 to 2018. We reviewed the medical records and applied the NSS formula to all included patients. RESULTS Eighty kidneys were operated on 56 patients at a mean age of 19.2 months (4 days-7.5 years), with 49 partial nephrectomies and 31 tumorectomies. The assessment of the surgical resection margins (SRM) showed a doubt in six cases and one tumor breach. An intact pseudocapsule along the resection margin with no renal parenchyma was found in four cases at pathological resection margins (PRM) assessment, whereas a tumor breach was described in seven cases. Among the six patients with a surgical doubt, only one had a pathological stage III. There were no surgical doubts in the seven patients with tumor breach at pathology. At a mean follow-up of eight years (15 days-28.6 years), eight patients had elevated blood pressure levels. Ten had proteinuria. These two parameters were significantly increased in patients with a remaining renal parenchyma (RRP) of less than half of the initial total renal parenchyma. The serum creatinine level was normal for all except two patients. CONCLUSION The new NSS formula described all the crucial elements of NSS. RRP seemed essential for the evaluation of long-term renal function.
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Affiliation(s)
- Chaima Mrad
- Pediatric Surgery Department, Sorbonnes Universités, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Aurore Coulomb-Lhermine
- Pathology Department, Sorbonnes Universités, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Marie-Dominique Tabone
- Pediatric Oncology Department, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Tim Ulinski
- Pediatric Nephrology Department, Sorbonnes Universités, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Georges Audry
- Pediatric Surgery Department, Sorbonnes Universités, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Sabine Irtan
- Pediatric Surgery Department, Sorbonnes Universités, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France
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Delessard M, Saulnier J, Dumont L, Rives-Feraille A, Rives N, Rondanino C. Paradoxical risk of reduced fertility after exposure of prepubertal mice to vincristine or cyclophosphamide at low gonadotoxic doses in humans. Sci Rep 2020; 10:17859. [PMID: 33082498 PMCID: PMC7576200 DOI: 10.1038/s41598-020-74862-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/10/2020] [Indexed: 11/09/2022] Open
Abstract
Cancer treatment can have long-term side effects in cured patients and infertility is one of them. Given the urgency of diagnosis in children with cancer, the toxicity of treatments on the gonad was overshadowed for a long time. In the present study, prepubertal mice were treated by vincristine or cyclophosphamide commonly used in acute leukaemia treatment. The prepubertal exposure to cyclophosphamide, at a low gonadotoxic dose in humans (< 3.5 g/m2), led to morphological alterations of prepubertal testicular tissue. An increased proportion of spermatozoa with hypocondensed chromatin and oxidized DNA associated with decreased fertility were uncovered at adulthood. Short- and long-term morphological alterations of the testicular tissue, disturbed progression of spermatogenesis along with increased proportions of isolated flagella and spermatozoa with fragmented DNA were evidenced in vincristine-treated mice. Moreover, the fertility of mice exposed to vincristine was severely affected despite being considered low-risk for fertility in humans. Paternal exposure to vincristine or cyclophosphamide before puberty had no impact on offspring development. Contrary to the current gonadotoxic risk classification, our results using a mouse model show that vincristine and cyclophosphamide (< 3.5 g/m2) present a high gonadotoxic risk when administered before the initiation of spermatogenesis.
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Affiliation(s)
- Marion Delessard
- Department of Reproductive Biology-CECOS, EA 4308 "Gametogenesis and Gamete Quality", Rouen University Hospital, Normandie Univ, UNIROUEN, 76000, Rouen, France
| | - Justine Saulnier
- Department of Reproductive Biology-CECOS, EA 4308 "Gametogenesis and Gamete Quality", Rouen University Hospital, Normandie Univ, UNIROUEN, 76000, Rouen, France
| | - Ludovic Dumont
- Department of Reproductive Biology-CECOS, EA 4308 "Gametogenesis and Gamete Quality", Rouen University Hospital, Normandie Univ, UNIROUEN, 76000, Rouen, France
| | - Aurélie Rives-Feraille
- Department of Reproductive Biology-CECOS, EA 4308 "Gametogenesis and Gamete Quality", Rouen University Hospital, Normandie Univ, UNIROUEN, 76000, Rouen, France
| | - Nathalie Rives
- Department of Reproductive Biology-CECOS, EA 4308 "Gametogenesis and Gamete Quality", Rouen University Hospital, Normandie Univ, UNIROUEN, 76000, Rouen, France
| | - Christine Rondanino
- Department of Reproductive Biology-CECOS, EA 4308 "Gametogenesis and Gamete Quality", Rouen University Hospital, Normandie Univ, UNIROUEN, 76000, Rouen, France.
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Bertin H, Gomez-Brouchet A, Rédini F. Osteosarcoma of the jaws: An overview of the pathophysiological mechanisms. Crit Rev Oncol Hematol 2020; 156:103126. [PMID: 33113487 DOI: 10.1016/j.critrevonc.2020.103126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/18/2020] [Accepted: 10/02/2020] [Indexed: 01/24/2023] Open
Abstract
Osteosarcoma (OS) is the most common cancer of bone. Jaw osteosarcoma (JOS) is rare and it differs from long-bone OS (LBOS) in terms of the time of onset (two decades later), lower metastatic spread, and better survival. OS is characterized by the proliferation of osteoblastic precursor cells and the production of osteoid or immature bone. OS arises from a combination of genetic aberrations and a favourable microenvironment. This local microenvironment includes bone cells, blood vessels, stromal cells, and immune infiltrates, all of which may constitute potential targets for anti-cancer drugs. Differences in the clinical and biological behaviour of JOS versus LBOS are likely to at least in part be due to differences in the microenvironment between the two sites. The present review provides a brief overview of the known pathophysiological parameters involved in JOS.
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Affiliation(s)
- Hélios Bertin
- Department of Maxillofacial Surgery, Nantes University Hospital, 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France; Bone Sarcoma and Remodeling of Calcified Tisues (PhyOs, UMR 1238), Nantes Medical School, 1 Rue Gaston Veil, 44035 Nantes Cedex, France.
| | - A Gomez-Brouchet
- Department of Pathology, IUCT Oncopole, Toulouse University Hospital, 1 Avenue Irène Joliot-Curie, 31059 Toulouse Cedex 9, France.
| | - F Rédini
- Bone Sarcoma and Remodeling of Calcified Tisues (PhyOs, UMR 1238), Nantes Medical School, 1 Rue Gaston Veil, 44035 Nantes Cedex, France.
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Collignon C, Brisse HJ, Lemelle L, Cardoen L, Gauthier A, Pierron G, Roussel A, Dumont B, Alimi A, Cordero C, Rouffiange L, Orbach D. [Diagnostic strategy in pediatrics soft tissue sarcomas]. Bull Cancer 2020; 107:963-971. [PMID: 32950242 DOI: 10.1016/j.bulcan.2020.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 06/09/2020] [Accepted: 06/18/2020] [Indexed: 02/08/2023]
Abstract
Soft tissue sarcomas in children are rare tumor, representing around 6 to 7% of children cancer. They spread mostly sporadically (90%) and therefore are rarely associated to an underlying constitutional genetic disease (10%). About half of those sarcomas are rhabdomyosarcomas and the others are a very heterogenous histologic group with various bio-pathologies and prognosis. Clinical presentation is mainly a soft tissue lump often difficult to distinguish from more frequent benign causes (malformative, infectious, benign, or pseudotumor). Inappropriate initial diagnosis work-up has a strong impact on soft tissue sarcomas' prognosis. Adapted complementary investigations (first ultrasound and MRI) are important to compile arguments for a malign origin and to indicate a biopsy. However, predictive value of imaging exams still remains imperfect, and histological analysis by percutaneous image-guided biopsy and sometimes by surgical biopsy is often necessary. Authors realize an update on optimal diagnostic pathway including molecular tests in presence of a soft tissue mass in a child.
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Affiliation(s)
- Charlotte Collignon
- Institut Curie, centre intégré de soins et de recherche en oncologie de l'enfant, adolescent et jeune adulte (SIREDO), 26, rue d'Ulm, 75005 Paris, France.
| | - Hervé J Brisse
- Institut Curie, département d'imagerie, 26, rue d'Ulm, 75005 Paris, France
| | - Lauriane Lemelle
- Institut Curie, centre intégré de soins et de recherche en oncologie de l'enfant, adolescent et jeune adulte (SIREDO), 26, rue d'Ulm, 75005 Paris, France
| | - Liesbeth Cardoen
- Institut Curie, département d'imagerie, 26, rue d'Ulm, 75005 Paris, France
| | - Arnaud Gauthier
- Institut Curie, département de médecine diagnostique et théranaustique, 26, rue d'Ulm, 75005 Paris, France
| | - Gaëlle Pierron
- Institut Curie, unité de génétique somatique, 26, rue d'Ulm, 75005 Paris, France
| | - Aphaia Roussel
- Hôpital Robert-Debré, service d'immuno-hématologie, 48, boulevard Sérurier, 75019 Paris, France
| | - Benoit Dumont
- Institut Curie, centre intégré de soins et de recherche en oncologie de l'enfant, adolescent et jeune adulte (SIREDO), 26, rue d'Ulm, 75005 Paris, France
| | - Aurélia Alimi
- Institut Curie, centre intégré de soins et de recherche en oncologie de l'enfant, adolescent et jeune adulte (SIREDO), 26, rue d'Ulm, 75005 Paris, France
| | - Camille Cordero
- Institut Curie, centre intégré de soins et de recherche en oncologie de l'enfant, adolescent et jeune adulte (SIREDO), 26, rue d'Ulm, 75005 Paris, France
| | - Lucie Rouffiange
- Institut Curie, centre intégré de soins et de recherche en oncologie de l'enfant, adolescent et jeune adulte (SIREDO), 26, rue d'Ulm, 75005 Paris, France
| | - Daniel Orbach
- Institut Curie, centre intégré de soins et de recherche en oncologie de l'enfant, adolescent et jeune adulte (SIREDO), 26, rue d'Ulm, 75005 Paris, France
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Maternal exposure to pesticides and risk of childhood lymphoma in France: A pooled analysis of the ESCALE and ESTELLE studies (SFCE). Cancer Epidemiol 2020; 68:101797. [PMID: 32882568 DOI: 10.1016/j.canep.2020.101797] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/29/2020] [Accepted: 08/02/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Few studies have assessed the relation between maternal prenatal pesticides use and childhood lymphoma risk, some reporting a positive association with non-Hodgkin lymphoma (NHL). We investigated the association between maternal exposure to pesticides during pregnancy and childhood Hodgkin (HL) and non-Hodgkin lymphoma. METHODS We pooled data from the two French national population-based case-control studies ESCALE (2003-2004) and ESTELLE (2010-2011). Data on domestic and occupational exposures to pesticides during pregnancy were obtained through standardised maternal interviews. Logistic regression models were used to compute odds ratios (OR) and 95% confidence intervals (CI) for HL and NHL, by pesticide category adjusted for potential confounders. Analyses by histological subtypes were also performed. RESULTS We included 328 H L, 305 non-Hodgkin NHL and 2,415 controls. Around 40% of control mothers reported having used pesticides during index pregnancy, of whom 95% reported insecticides use. Maternal use of herbicides and fungicides occurred mostly in combination with insecticides. Insecticides use was more frequently reported in cases than controls (ORNHL = 1.6 [95%CI 1.3-2.1], p = 0.0001; ORHL = 1.3 [95%CI 1.0-1.7], p = 0.03). This association appeared more marked for Burkitt lymphoma and mixed cellularity classical HL. No obvious association was observed with occupational pesticides exposure during pregnancy. CONCLUSION These results suggest that maternal domestic use of insecticides during pregnancy might be related to both childhood NHL and HL. Further larger studies are urgently needed.
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Coste A, Goujon S, Faure L, Hémon D, Clavel J. Agricultural crop density in the municipalities of France and incidence of childhood leukemia: An ecological study. ENVIRONMENTAL RESEARCH 2020; 187:109517. [PMID: 32438101 DOI: 10.1016/j.envres.2020.109517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Pesticide exposure is suspected to play a role in the etiology of childhood leukemia (AL). Various sources of exposure have been explored, but few studies have investigated the risk of childhood AL in relation to residential exposure to agricultural pesticides. Since around 50% of France is agricultural land, with marked pesticide use, France is a suitable location to investigate for an association. We aimed to analyze the association between the agricultural crop density in the municipalities of France and the incidence of childhood AL between 1990 and 2014. METHODS 11,487 cases of AL diagnosed in children aged 0-14 years were registered by the French National Registry of Childhood Hematological Malignancies over 1990-2014. National agricultural census data for 1990, 2000 and 2010 were used to estimate the densities of the most common crops in France. The incidence of AL was estimated in the 35,512 municipalities, by age and gender, and 3 observation periods, and expressed as the standardized incidence ratio (SIR). RESULTS We observed a moderate log-linear association between viticulture density and the incidence of AL, with a 3% increase in SIR for a 10% increase in viticulture density (SIRR = 1.03; 95%CI [1.00-1.06]). The association remained for lymphoblastic AL but not for myeloid AL. The association was stable after stratification by geographic area, age and period, and after adjustment on UV radiation and a French deprivation index. No consistent association was observed for other crop types. DISCUSSION This nationwide study shows a moderate increase in incidence of childhood AL in municipalities where viticulture is common. Future individual studies are needed to know whether this observation is confirmed and related to particular use of pesticides.
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Affiliation(s)
- Astrid Coste
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Villejuif, F-94807, France; Paris Descartes University, Sorbonne Paris Cité, France; Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland.
| | - Stéphanie Goujon
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Villejuif, F-94807, France; Paris Descartes University, Sorbonne Paris Cité, France.
| | - Laure Faure
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Villejuif, F-94807, France; Paris Descartes University, Sorbonne Paris Cité, France; French National Registry of Childhood Hematological,Malignancies, France
| | - Denis Hémon
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Villejuif, F-94807, France; Paris Descartes University, Sorbonne Paris Cité, France
| | - Jacqueline Clavel
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Villejuif, F-94807, France; Paris Descartes University, Sorbonne Paris Cité, France; French National Registry of Childhood Hematological,Malignancies, France
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Jones BC, Youlden DR, Cundy TP, O'Callaghan ME, Karpelowsky J, Aitken JF, McBride CA. Renal tumours in Australian children: 30 years of incidence, outcome and second primary malignancy data from the Australian Childhood Cancer Registry. J Paediatr Child Health 2020; 56:908-916. [PMID: 31943452 DOI: 10.1111/jpc.14774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 12/01/2019] [Accepted: 12/12/2019] [Indexed: 11/30/2022]
Abstract
AIM This paper describes the incidence and outcomes of childhood renal malignancies in Australia using national population-based data from the Australian Childhood Cancer Registry. METHODS De-identified data for children (0-14 years) diagnosed with renal malignancies from 1983 to 2015 inclusive were extracted. Cause-specific (CSS) and event-free survival up to 20 years from diagnosis were estimated using the cohort method. Adjusted excess mortality hazard ratios were calculated using a multivariable flexible parametric survival model. Details relating to second primary malignancies (SPMs) were also examined. RESULTS There were 1046 children diagnosed with renal malignancies in Australia between 1983 and 2015 (91% nephroblastoma), generating an annual age-standardised incidence rate of 8 per million children, which remained constant over the study period. CSS was 89% (95% confidence interval = 87-91%) and 88% (86-90%) at 5 and 20 years, respectively, and 5-year event-free survival was 82% (80-84%). Five-year CSS did not change over the study period and was highest for nephroblastoma (91%). Of the 94% of patients achieving remission, 15% relapsed and subsequent 5-year CSS was 49% (40%-58%). Eleven children were diagnosed with SPM (standardised incidence ratio = 2.9, 95% confidence interval = 1.6-5.3, P < 0.001), and five of them (45%) died within 5 years of the second diagnosis. CONCLUSIONS Children treated for renal malignancies in Australia have excellent long-term survival, which is unchanged since 1983. SPMs are uncommon following treatment for childhood renal cancer but carry a poor prognosis. Relapse carries a similarly poor prognosis to SPM but is more common. These data are comparable to registry outcomes in similarly developed nations.
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Affiliation(s)
- Brendan C Jones
- Department of Paediatric Surgery, Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, Brisbane, Queensland, Australia.,Discipline of Paediatrics and Child Health, University of Queensland, Brisbane, Queensland, Australia
| | - Danny R Youlden
- Australian Childhood Cancer Registry, Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Thomas P Cundy
- Department of Paediatric Surgery, Women's and Children's Hospital, Adelaide, South Australia, Australia.,Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
| | - Michael E O'Callaghan
- Department of Urology, Flinders Medical Centre, Adelaide, South Australia, Australia.,Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, South Australia, Australia.,Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Jonathan Karpelowsky
- Department of Paediatric Surgery, The Children's Hospital, Westmead, New South Wales, Australia.,Division of Child and Adolescent Health, University of Sydney, Westmead, New South Wales, Australia.,Children's Cancer Research Unit, Kids Research Institute, Westmead, New South Wales, Australia
| | - Joanne F Aitken
- Australian Childhood Cancer Registry, Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,School of Public Health, University of Queensland, Brisbane, Queensland, Australia.,Institute for Resilient Regions, University of Southern Queensland, Brisbane, Queensland, Australia
| | - Craig A McBride
- Department of Paediatric Surgery, Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, Brisbane, Queensland, Australia.,Discipline of Paediatrics and Child Health, University of Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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Non-Hodgkin Lymphoma Epidemiology in Children From 2 Socioeconomic Regions in Mexico: 20-Year Registry (1996-2015). J Pediatr Hematol Oncol 2020; 42:292-298. [PMID: 31688635 DOI: 10.1097/mph.0000000000001635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE We analyzed the epidemiologic characteristics of different types of non-Hodgkin Lymphoma (NHL), excluding Burkitt Lymphoma, in 2 Mexican regions with different socioeconomic status. MATERIALS AND METHODS In this surveillance study, we analyzed the incidence rates (cases per million children/year) of different types of NHL according to the ICCC3, registered in 1996-2015, from 2 different socioeconomic regions in Mexico: central and southern, with higher and lower status, respectively. RESULTS The principal NHL subgroups were precursor (IIb1), mature B cell (IIb2), mature T/NK cell, and no other specification (NOS; 42.3%, 15.8%, 14.1%, and 27.8%, respectively). In both regions, the overall incidence rates were similar (central=5.3, 95% confidence interval [CI], 4.6-6.1 vs. southern=6.3, 95% CI, 4.6-8.4); also, there were no differences by types (precursor cell LNH, 2.3 vs. 2.5; mature B cell, 0.9 vs. 0.8; mature T/NK cells, 0.8 vs. 0.8; and NOS, 1.4 vs. 2.3). In both regions, a decreasing trend was found (central= -0.17%, 95% CI, -0.03 to -0.3, P=0.04; southern= -0.32%, 95% CI, -0.07 to -0.57, P=0.02), with major reduction of NHL NOS from 1996 to 2000. In both regions, men predominated (2.1:1). CONCLUSIONS Socioeconomic status did not influence the incidence rates of NHL. In this study, we found a reduction of NHL NOS, possibly due to better typing.
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Konstantinoudis G, Schuhmacher D, Ammann RA, Diesch T, Kuehni CE, Spycher BD. Bayesian spatial modelling of childhood cancer incidence in Switzerland using exact point data: a nationwide study during 1985-2015. Int J Health Geogr 2020; 19:15. [PMID: 32303231 PMCID: PMC7165384 DOI: 10.1186/s12942-020-00211-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/11/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The aetiology of most childhood cancers is largely unknown. Spatially varying environmental factors such as traffic-related air pollution, background radiation and agricultural pesticides might contribute to the development of childhood cancer. This study is the first investigation of the spatial disease mapping of childhood cancers using exact geocodes of place of residence. METHODS We included 5947 children diagnosed with cancer in Switzerland during 1985-2015 at 0-15 years of age from the Swiss Childhood Cancer Registry. We modelled cancer risk using log-Gaussian Cox processes and indirect standardisation to adjust for age and year of diagnosis. We examined whether the spatial variation of risk can be explained by modelled ambient air concentration of NO2, modelled exposure to background ionising radiation, area-based socio-economic position (SEP), linguistic region, duration in years of general cancer registration in the canton or degree of urbanisation. RESULTS For all childhood cancers combined, the posterior median relative risk (RR), compared to the national level, varied by location from 0.83 to 1.13 (min to max). Corresponding ranges were 0.96 to 1.09 for leukaemia, 0.90 to 1.13 for lymphoma, and 0.82 to 1.23 for central nervous system (CNS) tumours. The covariates considered explained 72% of the observed spatial variation for all cancers, 81% for leukaemia, 82% for lymphoma and 64% for CNS tumours. There was weak evidence of an association of CNS tumour incidence with modelled exposure to background ionising radiation (RR per SD difference 1.17; 0.98-1.40) and with SEP (1.6; 1.00-1.13). CONCLUSION Of the investigated diagnostic groups, childhood CNS tumours showed the largest spatial variation. The selected covariates only partially explained the observed variation of CNS tumours suggesting that other environmental factors also play a role.
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Affiliation(s)
- Garyfallos Konstantinoudis
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
- Epidemiology and Biostatistics Department, School of Public Health, Imperial College London, London, UK.
| | - Dominic Schuhmacher
- Institute for Mathematical Stochastics, University of Göttingen, Göttingen, Germany
| | - Roland A Ammann
- Department of Paediatrics Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tamara Diesch
- Division of Paediatric Oncology/Haematology, University Children's Hospital Basel, Basel, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Ben D Spycher
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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Rios P, Bauer H, Schleiermacher G, Pasqualini C, Boulanger C, Thebaud E, Gandemer V, Pellier I, Verschuur A, Sudour-Bonnange H, Coulomb-l'Hermine A, Spiegel A, Notz-Carrere A, Bergeron C, Orsi L, Lacour B, Clavel J. Environmental exposures related to parental habits in the perinatal period and the risk of Wilms' tumor in children. Cancer Epidemiol 2020; 66:101706. [PMID: 32247207 DOI: 10.1016/j.canep.2020.101706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Wilms' tumor is the most frequently diagnosed renal tumor in children. Little is known about its etiology. The aim of this study was to investigate the potential role of specific exposures related to parental habits such as parental smoking, maternal alcohol consumption and the use of household pesticides during pregnancy. METHODS The ESTELLE study was a nationwide case-control study that included 117 Wilms' tumor cases and 1100 control children from the general French population, frequency-matched by age and gender. Unconditional logistic regression was used to estimate odds ratios and 95 % confidence intervals. RESULTS After controlling for matching variables and potential confounders, the maternal use of any type of pesticide during pregnancy was associated with the risk of Wilms' tumor in children (OR 1.6 [95 % CI 1.1-2.3]). Insecticides were the most commonly reported type of pesticide and there was a positive association with their use (OR 1.7 [95 % CI 1.1-2.6]. The association was stronger when they were used more often than once a month (OR 1.9 [95 % CI 1.2-3.0]. Neither maternal smoking during pregnancy nor paternal smoking during preconception/pregnancy was associated with a risk of Wilms' tumor (ORs 1.1[95 % CI 0.7-1.8] and 1.1 [95 % CI 0.7-1.7], respectively). No association was observed with maternal alcohol intake during pregnancy (OR 1.2 [95 % CI 0.8-2.0]). CONCLUSION Our findings suggest an association between the maternal use of household pesticides during pregnancy and the risk of Wilms' tumor.
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Affiliation(s)
- Paula Rios
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.
| | - Hélène Bauer
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | | | - Claudia Pasqualini
- Gustave Roussy, Université Paris-Saclay, Child and Adolescent Oncology Department, Villejuif, France
| | | | | | | | | | | | | | | | | | | | | | - Laurent Orsi
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | - Brigitte Lacour
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France; National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif and CHU de Nancy, France
| | - Jacqueline Clavel
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France; National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif and CHU de Nancy, France
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État des lieux des maladies onco-hématologiques pédiatriques en Corse et organisation des soins. Rev Epidemiol Sante Publique 2020; 68:75-82. [DOI: 10.1016/j.respe.2020.01.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 12/20/2019] [Accepted: 01/09/2020] [Indexed: 11/24/2022] Open
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43
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Infant cancers in France: Incidence and survival (2000–2014). Cancer Epidemiol 2020; 65:101697. [DOI: 10.1016/j.canep.2020.101697] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/28/2020] [Accepted: 02/29/2020] [Indexed: 12/24/2022]
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44
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Bauer H, Rios P, Schleiermacher G, Valteau-Couanet D, Bertozzi AI, Thebaud E, Gandemer V, Pellier I, Verschuur A, Spiegel A, Notz-Carrere A, Bergeron C, Orsi L, Lacour B, Clavel J. Maternal and perinatal characteristics, congenital malformations and the risk of wilms tumor: the ESTELLE study. Cancer Causes Control 2020; 31:491-501. [PMID: 32144681 DOI: 10.1007/s10552-020-01288-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/24/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Wilms tumor (WT), or nephroblastoma, is an embryonic tumor that constitutes the most common renal tumor in children. Little is known about the etiology of WT. The aim of this study was to investigate whether maternal or perinatal characteristics were associated with the risk of WT. METHODS The ESTELLE study is a national-based case-control study that included 117 cases of WT and 1,100 controls younger than 11 years old. The cases were children diagnosed in France in 2010-2011 and the controls were frequency matched with cases by age and gender. The mothers of case and control children responded to a telephone questionnaire addressing sociodemographic and perinatal characteristics, childhood environment, and lifestyle. Unconditional logistic regression models adjusted on potential cofounders were used to estimate the odds ratios (OR) and their confidence intervals (95% CI). RESULTS High birth weight and the presence of congenital malformation were associated with WT (OR 1.9 [95% CI 1.0-3.7] and OR 2.5 [95% CI 1.1-5.8], respectively). No association with breastfeeding or folic acid supplementation was observed. CONCLUSIONS Although potential recall bias cannot be excluded, our findings reinforce the hypothesis that high birth weight and the presence of congenital malformation may be associated with an increased risk of WT. Further investigations are needed to further elucidate the possible role of maternal characteristics in the etiology of WT.
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Affiliation(s)
- Hélène Bauer
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | - Paula Rios
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.
| | | | - Dominique Valteau-Couanet
- Children and Adolescent Cancerology Department, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | | | | | | | | | | | | | | | - Laurent Orsi
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | - Brigitte Lacour
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.,National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif, France.,CHU de Nancy, Nancy, France
| | - Jacqueline Clavel
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.,National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif, France.,CHU de Nancy, Nancy, France
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45
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Mazzei-Abba A, Folly CL, Coste A, Wakeford R, Little MP, Raaschou-Nielsen O, Kendall G, Hémon D, Nikkilä A, Spix C, Auvinen A, Spycher BD. Epidemiological studies of natural sources of radiation and childhood cancer: current challenges and future perspectives. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2020; 40:R1-R23. [PMID: 31751953 PMCID: PMC10654695 DOI: 10.1088/1361-6498/ab5a38] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The empirical estimation of cancer risks in children associated with low-dose ionising radiation (<100 mSv) remains a challenge. The main reason is that the required combination of large sample sizes with accurate and comprehensive exposure assessment is difficult to achieve. An international scientific workshop, 'Childhood cancer and background radiation', organised by the Institute of Social and Preventive Medicine of the University of Bern, brought together researchers in this field to evaluate how epidemiological studies of background radiation and childhood cancer can best improve our understanding of the effects of low-dose ionising radiation. This review summarises and evaluates the findings of these studies with regard to their methodological differences, identifies key limitations and challenges, and proposes ways to move forward. Large childhood cancer registries, such as those in Great Britain, France and Germany, now permit the conducting of studies that should have sufficient statistical power to detect the effects predicted by standard risk models. Nevertheless, larger studies or pooled studies will be needed to investigate disease subgroups. The main challenge is to accurately assess children's individual exposure to radiation from natural sources and from other sources, as well as potentially confounding non-radiation exposures, in such large study populations. For this, the study groups should learn from each other to improve exposure estimation and develop new ways to validate exposure models with personal dosimetry.
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Affiliation(s)
- Antonella Mazzei-Abba
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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Delessard M, Saulnier J, Rives A, Dumont L, Rondanino C, Rives N. Exposure to Chemotherapy During Childhood or Adulthood and Consequences on Spermatogenesis and Male Fertility. Int J Mol Sci 2020; 21:ijms21041454. [PMID: 32093393 PMCID: PMC7073108 DOI: 10.3390/ijms21041454] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/09/2020] [Accepted: 02/13/2020] [Indexed: 01/23/2023] Open
Abstract
Over the last decade, the number of cancer survivors has increased thanks to progress in diagnosis and treatment. Cancer treatments are often accompanied by adverse side effects depending on the age of the patient, the type of cancer, the treatment regimen, and the doses. The testicular tissue is very sensitive to chemotherapy and radiotherapy. This review will summarize the epidemiological and experimental data concerning the consequences of exposure to chemotherapy during the prepubertal period or adulthood on spermatogenic progression, sperm production, sperm nuclear quality, and the health of the offspring. Studies concerning the gonadotoxicity of anticancer drugs in adult survivors of childhood cancer are still limited compared with those concerning the effects of chemotherapy exposure during adulthood. In humans, it is difficult to evaluate exactly the toxicity of chemotherapeutic agents because cancer treatments often combine chemotherapy and radiotherapy. Thus, it is important to undertake experimental studies in animal models in order to define the mechanism involved in the drug gonadotoxicity and to assess the effects of their administration alone or in combination on immature and mature testis. These data will help to better inform cancer patients after recovery about the risks of chemotherapy for their future fertility and to propose fertility preservation options.
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Roche J, Câmara-Costa H, Roulin JL, Chevignard M, Frappaz D, Guichardet K, Benkhaled O, Kerrouche B, Prodhomme J, Kieffer-Renaux V, Le Gall D, Fournet N, Roy A. Assessment of everyday executive functioning using the BRIEF in children and adolescents treated for brain tumor. Brain Inj 2020; 34:583-590. [DOI: 10.1080/02699052.2020.1725982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Jeanne Roche
- Laboratory of Psychology Pays de la Loire, EA4638, UBL, Angers University, Angers, France
- SMAEC, Resource Centre for Children, Adolescents, Young Adults with Acquired Neurological Injury, Miribel, France
| | - Hugo Câmara-Costa
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- Laboratoire d’Imagerie Biomédicale, LIB, Sorbonne Université, Paris, France
| | - Jean-Luc Roulin
- University Grenoble Alpes, University Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
| | - Mathilde Chevignard
- Laboratoire d’Imagerie Biomédicale, LIB, Sorbonne Université, Paris, France
- Rehabilitation Department for children with acquired neurological injury, and Outreach team for children and adolescents with acquired brain injury, Saint Maurice Hospitals, Saint Maurice, France
- GRC 24 HaMCRe, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France
| | - Didier Frappaz
- Institut d’Hématologie et d’Oncologie Pédiatrique, Lyon, France
| | - Karine Guichardet
- Medical Clinic of Paediatrics, HCE, CHU de Grenoble Alpes, Grenoble, France
| | - Ouarda Benkhaled
- Rehabilitation Department for children with acquired neurological injury, and Outreach team for children and adolescents with acquired brain injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Bernadette Kerrouche
- Rehabilitation Department for children with acquired neurological injury, and Outreach team for children and adolescents with acquired brain injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Julie Prodhomme
- Rehabilitation Department for children with acquired neurological injury, and Outreach team for children and adolescents with acquired brain injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Virginie Kieffer-Renaux
- Rehabilitation Department for children with acquired neurological injury, and Outreach team for children and adolescents with acquired brain injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Didier Le Gall
- Laboratory of Psychology Pays de la Loire, EA4638, UBL, Angers University, Angers, France
- Département de neurologie, CHU d’Angers, Université Bretagne Loire, France
| | - Nathalie Fournet
- University Grenoble Alpes, University Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
| | - Arnaud Roy
- Laboratory of Psychology Pays de la Loire, EA4638, UBL, Angers University, Angers, France
- Centre Référent des Troubles d’Apprentissage, Centre de Compétence Nantais de Neurofibromatose, Hôpital Femme-Enfant-Adolescent, CHU de Nantes, Nantes, France
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Valteau-Couanet D, Minard-Colin V, Pasqualini C. [Anti-GD2 antibodies in treatment of high-risk Neuroblastoma: present and perspectives]. Med Sci (Paris) 2020; 35:997-1000. [PMID: 31903906 DOI: 10.1051/medsci/2019197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Neuroblastoma is the most frequent extra-cranial pediatric solid tumor, occurring in young children, 90% being less than 5 years at diagnosis. It remains a therapeutic challenge since survival of high-risk neuroblastoma patients that represent around 50% of the patients is around 50% in spite of extensive combined treatments. Immunotherapy based on the use of antibodies directed to GD2, a ganglioside strongly expressed by almost all neuroblastoma cells, has been developed during the last decade. In SIOPEN studies have shown that dinatuximab beta (Qarziba®) is effective on refractory/relapsed patients and improves survival when administered in the first line maintenance treatment. Other strategies are currently explored using combination with chemotherapy at relapse and evaluating the benefits of an earlier administration during the induction treatment. In addition, more selective antibodies are also developed to decrease toxicity, especially neuropathic pain that is one of the major toxic effect.
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Affiliation(s)
| | - Véronique Minard-Colin
- Département de Cancérologie de l'enfant et de l'adolescent, Gustave Roussy, 94800 Villejuif, France
| | - Claudia Pasqualini
- Département de Cancérologie de l'enfant et de l'adolescent, Gustave Roussy, 94800 Villejuif, France
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Roussel A. [Evolution of pharmacological treatments in paediatric oncology]. SOINS; LA REVUE DE RÉFÉRENCE INFIRMIÈRE 2020; 64:30-33. [PMID: 31864509 DOI: 10.1016/j.soin.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
With around 1 800 new cases each year in children under the age of 15 and 800 new cases a year in teenagers, childhood cancers are a major public health issue. Chemotherapy remains a key component in the treatment of childhood cancers but the advances made in genetics has opened the way to targeted therapies which enable the treatment to be adapted to each child significantly improving survival and reducing sequelae.
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Balasubramanian D, Subramaniam N, Ramu J, Sood R, Sharma M, Mathew J, Thankappan K, Subhash P, Krishnadas A, Iyer S. Microvascular reconstruction for tumors of the head and neck in the pediatric population. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS 2020. [DOI: 10.4103/jhnps.jhnps_37_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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