Neurological hospitalisations in childhood cancer survivors treated before 2001: findings from the French Childhood Cancer Survivor Study cohort.
Childhood cancer survivor
Hospitalisations
Neurological diseases
Risk factor
Journal
BMC neurology
ISSN: 1471-2377
Titre abrégé: BMC Neurol
Pays: England
ID NLM: 100968555
Informations de publication
Date de publication:
10 Sep 2024
10 Sep 2024
Historique:
received:
05
12
2023
accepted:
09
08
2024
medline:
11
9
2024
pubmed:
11
9
2024
entrez:
10
9
2024
Statut:
epublish
Résumé
Childhood cancer survivors (CCS) have an increased risk of developing late chronic diseases, which can be influenced by the cancer type and its treatment. These chronic diseases can be severe and disabling, typically emerging years to decades after treatment. These deficits negatively impact quality of life, intelligence quotient, and memory. This study investigated how much the cancer type and treatment could affect the neurological hospitalisations in the French Childhood Cancer Survivors Study (FCCSS). We included 5579 childhood cancer survivors (CCS), diagnosed with solid tumours or lymphoma between 1945 and 2000, treated before 2001 and below the age of 21 years at initial treatment. The follow-up period was from 2006 to 2018. Hospitalisation data were obtained by linkage with the National Health Data System. We calculated the relative hospitalisation rate (RHRs) and absolute excess rate (AERs). Multivariable analyses were conducted using a Generalized Linear Model (GLM) with a Poisson distribution to estimate the association between neurological hospitalisation and patient characteristics. The expected number of hospitalisations served as an offset to compare the risk for FCCSS survivors with that of the reference population. Risk estimates were reported as relative risk (RR) with 95% confidence intervals. The hospitalisation rate for CCS was 114.2 per 10,000 person-years (PY), compared to 48.4 in the reference population. The highest hospitalisation rates were observed for epilepsy (AER = 27.1 per 10000 PY, 95%CI: 23.5-31.2 and RHR = 5.1, 95%CI 4.4-5.7). In multivariable analyses, central nervous system (CNS) tumours survivors had the highest relative risk (RR) of hospitalisation (RR = 9.4, 95%CI: 6.7-13.1) followed by neuroblastoma survivors (RR = 2.5, 95%CI: 1.7-3.7). In the whole population, survivors who received radiation to the head and neck had a significantly higher risk of hospitalisation (RR = 3.9, 95%CI: 3.3-4.7) compared to those who did not receive radiotherapy. Head and neck irradiation was identified as a strong risk factor for hospitalisation. This underlines the importance of implementing specific neurologic surveillance programs for at-risk individuals.
Identifiants
pubmed: 39256648
doi: 10.1186/s12883-024-03797-8
pii: 10.1186/s12883-024-03797-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
335Subventions
Organisme : Institut National Du Cancer
ID : INCA RISP-SHS 2022
Informations de copyright
© 2024. The Author(s).
Références
Armstrong GT, Yasui Y, Robison LL. Reduction in late mortality after Childhood Cancer. N Engl J Med. 2016;375(3). https://doi.org/10.1056/NEJMc1604184 .
Tsimberidou AM, et al. Review of precision cancer medicine: evolution of the treatment paradigm. Cancer Treat Rev. 2020;86. https://doi.org/10.1016/j.ctrv.2020.102019 .
Botta L, et al. Long-term survival and cure fraction estimates for childhood cancer in Europe (EUROCARE-6): results from a population-based study. Lancet Oncol. 2022;23(12). https://doi.org/10.1016/S1470-2045(22)00637-4 .
Hudson MM, et al. Clinical ascertainment of health outcomes among adults treated for childhood cancer. JAMA. 2013;309(22). https://doi.org/10.1001/jama.2013.6296 .
Oeffinger KC, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med. 2006;355(15). https://doi.org/10.1056/NEJMsa060185 .
Diller L, et al. Chronic disease in the Childhood Cancer Survivor Study cohort: a review of published findings. J Clin Oncol. 2009;27(14). https://doi.org/10.1200/jco.2008.21.1953 .
Mohrmann C, et al. Neurocognitive outcomes and school performance in solid tumor cancer survivors lacking therapy to the central nervous system. J Pers Med. 2015;5(2). https://doi.org/10.3390/jpm5020083 .
Bhakta N, et al. The cumulative burden of surviving childhood cancer: an initial report from the St Jude Lifetime Cohort Study (SJLIFE). Lancet. 2017;390(10112). https://doi.org/10.1016/s0140-6736(17)31610-0 .
Cheung YT, et al. Chronic health conditions and neurocognitive function in aging survivors of Childhood Cancer: a report from the Childhood Cancer Survivor Study. J Natl Cancer Inst. 2018;110(4). https://doi.org/10.1093/jnci/djx224 .
Champaloux SW, Young DR. Childhood chronic health conditions and educational attainment: a social ecological approach. J Adolesc Health. 2015;56(1). https://doi.org/10.1016/j.jadohealth.2014.07.016 .
Vassilaki M, et al. Multimorbidity and risk of mild cognitive impairment. J Am Geriatr Soc. 2015;63(9). https://doi.org/10.1111/jgs.13612 .
Clanton NR, et al. Fatigue, vitality, sleep, and neurocognitive functioning in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Cancer. 2011;117(11). https://doi.org/10.1002/cncr.25797 .
Krull KR, et al. Neurocognitive outcomes decades after treatment for childhood acute lymphoblastic leukemia: a report from the St Jude lifetime cohort study. J Clin Oncol. 2013;31(35). https://doi.org/10.1200/jco.2012.48.2315 .
Grill J, et al. Critical risk factors for intellectual impairment in children with posterior fossa tumors: the role of cerebellar damage. J Neurosurg. 2004;101(2 Suppl). https://doi.org/10.3171/ped.2004.101.2.0152 .
Blauwblomme T, et al. Forniceal glioma in children. Clinical article. J Neurosurg Pediatr. 2009;4(3). https://doi.org/10.3171/2009.4.Peds08472 .
Krull KR, et al. Neurocognitive function and CNS integrity in adult survivors of childhood hodgkin lymphoma. J Clin Oncol. 2012;30(29). https://doi.org/10.1200/jco.2012.42.6841 .
Bejarano-Quisoboni D, et al. Long-term hospitalisations in survivors of paediatric solid tumours in France. Sci Rep. 2022;12(1). https://doi.org/10.1038/s41598-022-22689-w .
Kenborg L, et al. Hospital admission for neurologic disorders among 5-year survivors of noncentral nervous system tumors in childhood: a cohort study within the adult life after Childhood Cancer in Scandinavia study. Int J Cancer. 2020;146(3). https://doi.org/10.1002/ijc.32341 .
Kenborg L, et al. Neurologic disorders in 4858 survivors of central nervous system tumors in childhood-an adult life after Childhood Cancer in Scandinavia (ALiCCS) study. Neuro Oncol. 2019;21(1). https://doi.org/10.1093/neuonc/noy094 .
Journy NMY, et al. Risk factors of subsequent Central Nervous System tumors after Childhood and adolescent cancers: findings from the French Childhood Cancer Survivor Study. Cancer Epidemiol Biomarkers Prev. 2021;30(1). https://doi.org/10.1158/1055-9965.epi-20-0735 .
de Vathaire F et al. Solid malignant neoplasms after childhood irradiation: decrease of the relative risk with time after irradiation. C R Acad Sci III, 1995. 318(4).
Haddy N, et al. Cardiac diseases following Childhood Cancer Treatment: Cohort Study. Circulation. 2016;133(1). https://doi.org/10.1161/circulationaha.115.016686 .
Bejarano-Quisoboni D, et al. Health care expenditures among long-term survivors of pediatric solid tumors: results from the French Childhood Cancer Survivor Study (FCCSS) and the French network of cancer registries (FRANCIM). PLoS ONE. 2022;17(5). https://doi.org/10.1371/journal.pone.0267317 .
Bezin J, et al. The national healthcare system claims databases in France, SNIIRAM and EGB: powerful tools for pharmacoepidemiology. Pharmacoepidemiol Drug Saf. 2017;26(8). https://doi.org/10.1002/pds.4233 .
Tuppin P, et al. Value of a national administrative database to guide public decisions: From the systeme national d’information interregimes de l’Assurance Maladie (SNIIRAM) to the systeme national des donnees de sante (SNDS) in France. Rev Epidemiol Sante Publique. 2017;65(Suppl 4). https://doi.org/10.1016/j.respe.2017.05.004 .
Fieller EC. Some problems in interval estimation. J Royal Stat Soc Ser B (Methodological), 1954. 16(2).
Streefkerk N, et al. A detailed insight in the high risks of hospitalizations in long-term childhood cancer survivors-A Dutch LATER linkage study. PLoS ONE. 2020;15(5). https://doi.org/10.1371/journal.pone.0232708 .
de Fine Licht S, et al. Long-term inpatient disease burden in the adult life after Childhood Cancer in Scandinavia (ALiCCS) study: a cohort study of 21,297 childhood cancer survivors. PLoS Med. 2017;14(5). https://doi.org/10.1371/journal.pmed.1002296 .
Kirchhoff AC, et al. Risk of hospitalization for survivors of childhood and adolescent cancer. Cancer Epidemiol Biomarkers Prev. 2014;23(7). https://doi.org/10.1158/1055-9965.epi-13-1090 .
Kurt BA, et al. Hospitalization rates among survivors of childhood cancer in the Childhood Cancer Survivor Study cohort. Pediatr Blood Cancer. 2012;59(1). https://doi.org/10.1002/pbc.24017 .
Agapito I, et al. Neuropsychiatric complications and associated management in adolescent and young adult cancer survivors: an all of us study. Cancer Med. 2023. https://doi.org/10.1002/cam4.6641 .
doi: 10.1002/cam4.6641
pubmed: 37902258
pmcid: 10709746
Norsker FN, et al. Neurologic disorders in long-term survivors of neuroblastoma - a population-based cohort study within the adult life after Childhood Cancer in Scandinavia (ALiCCS) research program. Acta Oncol. 2020;59(2). https://doi.org/10.1080/0284186x.2019.1672892 .
Wells EM, et al. Longitudinal assessment of late-onset neurologic conditions in survivors of childhood central nervous system tumors: a Childhood Cancer Survivor Study report. Neuro Oncol. 2018;20(1). https://doi.org/10.1093/neuonc/nox148 .
Krull KR, et al. Neurocognitive outcomes and interventions in long-term survivors of Childhood Cancer. J Clin Oncol. 2018;36(21). https://doi.org/10.1200/jco.2017.76.4696 .
Sun LR, Cooper S. Neurological complications of the treatment of Pediatric Neoplastic disorders. Pediatr Neurol. 2018;85. https://doi.org/10.1016/j.pediatrneurol.2018.05.011 .
Ochs JJ, et al. Seizures in childhood lymphoblastic leukaemia patients. Lancet. 1984;2:8417–8. https://doi.org/10.1016/s0140-6736(84)91621-0 .
doi: 10.1016/s0140-6736(84)91621-0
Green DM, et al. Relevance of historical therapeutic approaches to the contemporary treatment of pediatric solid tumors. Pediatr Blood Cancer. 2013;60(7). https://doi.org/10.1002/pbc.24487 .
https:// www.atih.sante.fr/sites/default/files/public/content/3675/synthese_aah_2018_v2.pdf , Synthèse Analyse de l’activité hospitalière 2018 2018.
Tuppin P, et al. French national health insurance information system and the permanent beneficiaries sample. Rev Epidemiol Sante Publique. 2010;58(4). https://doi.org/10.1016/j.respe.2010.04.005 .
Haden MA, Keats TE. Congenital intraspinal neuroblastoma with intraspinal calcification in the neonatal period: report of a case with a 32-year follow-up. Pediatr Radiol. 1983;13(6). https://doi.org/10.1007/BF01625961 .
Połczyńska K et al. [Neurologic symptoms in the course of neuroblastoma in children. Own observations]. Med Wieku Rozwoj, 2005. 9(3 Pt 2).
Dyken P, Kolár O. Dancing eyes, dancing feet: infantile polymyoclonia. Brain. 1968;91(2). https://doi.org/10.1093/brain/91.2.305 .
Du H, Cai W. Opsoclonus-Myoclonus syndrome associated with neuroblastoma: insights into antitumor immunity. Pediatr Blood Cancer. 2022;69(11). https://doi.org/10.1002/pbc.29949 .