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Beijer, J.G.M.; Kok, J.L.; Janssens, G.O.; Streefkerk, N.; Vries, A.C.H. de; Slagter, C.; ... ; Ronckers, C.M. (2023)

Adverse late health outcomes among children treated with 3D radiotherapy techniques: study design of the Dutch pediatric 3D-RT study

Article / Letter to editor
Background: Adverse late health outcomes after multimodal treatment for pediatric cancer are diverse and of prime interest. Currently available evidence and survivorship care guidelines are largely based on studies addressing side-effects of two dimensional planned radiotherapy. Aims: The Dutch pediatric 3D-planned radiotherapy (3D-RT) study aims to gain insight in the long-term health outcomes among children who had radiotherapy in the 3D era. Here, we describe the study design, data-collection methods, and baseline cohort characteristics. Methods and Results: The 3D-RT study represents an expansion of the Dutch Childhood Cancer Survivor study (DCCSS) LATER cohort, including pediatric cancer patients diagnosed during 2000-2012, who survived at least 5 years after initial diagnosis and 2 years post external beam radiotherapy. Individual cancer treatment parameters were obtained from medical files. A national infrastructure for uniform collection and archival of digital...Show moreBackground: Adverse late health outcomes after multimodal treatment for pediatric cancer are diverse and of prime interest. Currently available evidence and survivorship care guidelines are largely based on studies addressing side-effects of two dimensional planned radiotherapy. Aims: The Dutch pediatric 3D-planned radiotherapy (3D-RT) study aims to gain insight in the long-term health outcomes among children who had radiotherapy in the 3D era. Here, we describe the study design, data-collection methods, and baseline cohort characteristics. Methods and Results: The 3D-RT study represents an expansion of the Dutch Childhood Cancer Survivor study (DCCSS) LATER cohort, including pediatric cancer patients diagnosed during 2000-2012, who survived at least 5 years after initial diagnosis and 2 years post external beam radiotherapy. Individual cancer treatment parameters were obtained from medical files. A national infrastructure for uniform collection and archival of digital radiotherapy files (Computed Tomography [CT]-scans, delineations, plan, and dose files) was established. Health outcome information, including subsequent tumors, originated from medical records at the LATER outpatient clinics, and national registry-linkage. With a median follow-up of 10.9 (interquartile range [IQR]: 7.9-14.3) years after childhood cancer diagnosis, 711 eligible survivors were identified. The most common cancer types were Hodgkin lymphoma, medulloblastoma, and nephroblastoma. Most survivors received radiotherapy directed to the head/cranium only, the craniospinal axis, or the abdominopelvic region. Conclusion: The 3D-RT study will provide knowledge on the risk of adverse late health outcomes and radiation-associated dose-effect relationships. This information is valuable to guide follow-up care of childhood cancer survivors and to refine future treatment protocols.Show less
pediatric radiotherapy
childhood cancer survivors
side effects
study design
radiation dose effects
All authors
Beijer, J.G.M.; Kok, J.L.; Janssens, G.O.; Streefkerk, N.; Vries, A.C.H. de; Slagter, C.; Maduro, J.H.; Kroon, P.S.; Grootenhuis, M.A.; Broeder, E.V.; Loonen, J.J.; Wendling, M.; Tissing, W.J.E.; Pal, H.J. van der; Louwerens, M.; Bel, A.; Hartogh, J. den; Loo, M.V.V. van der van der; Kremer, L.C.M.; Teepen, J.C.; Ronckers, C.M.
Date
2023-01-30
Journal
Cancer Reports
Volume
6
Issue
2
DOI
doi:10.1002/cnr2.1620