論文

査読有り 国際誌
2019年11月1日

Late-onset anorectal disease and psychosocial impact in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

Cancer
  • Arin L. Madenci
  • ,
  • Bryan V. Dieffenbach
  • ,
  • Qi Liu
  • ,
  • Daisuke Yoneoka
  • ,
  • Jamie Knell
  • ,
  • Todd M. Gibson
  • ,
  • Yutaka Yasui
  • ,
  • Wendy M. Leisenring
  • ,
  • Rebecca M. Howell
  • ,
  • Lisa R. Diller
  • ,
  • Kevin R. Krull
  • ,
  • Gregory T. Armstrong
  • ,
  • Kevin C. Oeffinger
  • ,
  • Andrew J. Murphy
  • ,
  • Brent R. Weil
  • ,
  • Christopher B. Weldon

125
21
開始ページ
3873
終了ページ
3881
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1002/cncr.32395
出版者・発行元
WILEY

© 2019 American Cancer Society Background: The prevalence and associated psychosocial morbidity of late-onset anorectal disease after surgery and radiotherapy for the treatment of childhood cancer are not known. Methods: A total of 25,530 survivors diagnosed between 1970 and 1999 (median age at cancer diagnosis, 6.1 years; age at survey, 30.2 years) and 5036 siblings were evaluated for late-onset anorectal disease, which was defined as a self-reported fistula-in-ano, self-reported anorectal stricture, or pathology- or medical record–confirmed anorectal subsequent malignant neoplasm (SMN) 5 or more years after the primary cancer diagnosis. Piecewise exponential models compared the survivors and siblings and examined associations between cancer treatments and late-onset anorectal disease. Multiple logistic regression with generalized estimating equations was used to evaluate associations between late-onset anorectal disease and emotional distress, as defined by the Brief Symptom Inventory 18 (BSI-18), and health-related quality of life, as defined by the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). Results: By 45 years after the diagnosis, 394 survivors (fistula, n = 291; stricture, n = 116; anorectal SMN, n = 26) and 84 siblings (fistula, n = 73; stricture, n = 23; anorectal neoplasm, n = 1) had developed late-onset anorectal disease (adjusted rate ratio [RR] for survivors vs siblings, 1.2; 95% confidence interval [CI], 1.0-1.5). Among survivors, pelvic radiotherapy with ≥30 Gy within 5 years of the cancer diagnosis was associated with late-onset anorectal disease (adjusted RR for 30-49.9 Gy vs none, 1.6; 95% CI, 1.1-2.3; adjusted RR for ≥50 Gy vs none, 5.4; 95% CI, 3.1-9.2). Late-onset anorectal disease was associated with psychosocial impairment in all BSI-18 and SF-36 domains. Conclusions: Late-onset anorectal disease was more common among childhood cancer survivors who received higher doses of pelvic radiotherapy and was associated with substantial psychosocial morbidity.

Web of Science ® 被引用回数 : 1

リンク情報
DOI
https://doi.org/10.1002/cncr.32395
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31322729
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788933
Scopus
https://www.scopus.com/record/display.uri?eid=2-s2.0-85069720664&origin=inward
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000477265900001&DestApp=WOS_CPL
Scopus
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85069720664&origin=inward
Scopus Citedby
https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85069720664&origin=inward

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