Page 417 - 2014 Printable Abstract Book
P. 417
(PS7-67) Design of a nested case-control study to assess the radiation dose-response relationship for
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basal cell carcinoma in childhood cancer survivors: a DCOG LATER study. Jop C. Teepen, MSc ; Flora E.
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2
4
van Leeuwen, PhD ; Wim J.E. Tissing, MD PhD ; Marry M. van den Heuvel-Eibrink, MD PhD ; Eline van
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7
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Dulmen-den Broeder, PhD ; Birgitta Versluys, MD ; Dorine Bresters, MD PhD ; Jacqueline J. Loonen, MD
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PhD ; Huib N. Caron, MD PhD ; Tamar E. Nijsten, MD PhD ; Marijke R. van Dijk, MD PhD ; DCOG LATER
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11
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Study Group (see appendix) ; Marilyn Stovall, PhD ; Rita E. Weathers, MS ; Susan A. Smith, MPH ;
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Leontien C.M. Kremer, MD PhD ; and Cécile M. Ronckers, PhD ; Emma Children's Hospital / Academic
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Medical Center, Amsterdam, Netherlands ; Netherlands Cancer Institute, Amsterdam, Netherlands ;
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University Medical Center Groningen, Groningen, Netherlands ; Erasmus Medical Center / Sophia
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Children’s Hospital, Rotterdam, Netherlands ; VU University Medical Center, Amsterdam, Netherlands ;
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University Medical Center Utrecht, Utrecht, Netherlands ; Leiden University Medical Center, Leiden,
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Netherlands ; Radboud University Medical Center, Nijmegen, Netherlands ; Erasmus Medical Center,
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10
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Rotterdam, Netherlands ; Dutch Childhood Oncology Group, Den Haag, Netherlands ; and The University
of Texas MD Anderson Cancer Center, Houston, TX 11
Introduction: Basal cell carcinoma (BCC) is the most common second malignancy among
childhood cancer survivors (CCS), in particular following radiotherapy. Despite low mortality rates, quality
of life is negatively impacted by a new cancer diagnosis as well as the associated cosmetic disfigurement
from surgical removal of (multiple) BCCs. More insight into the dose-effect relationship for radiotherapy
and BCC will identify subgroups at high and at low risk for BCC, thereby facilitating recommendations for
long-term CCS patient education and surveillance. Our aims are to evaluate the shape and magnitude of
the radiation dose-response relationship for BCC and to examine potential modifying factors such as sex,
age at exposure, childhood cancer type, chemotherapy, bone marrow transplant, skin type, and skin
pigmentation on the radiation dose-response for BCC. Methods: The DCOG LATER Study Group assembled
a nationwide cohort of 6,168 Dutch 5-year CCS diagnosed between 1963 and 2002. Detailed patient and
treatment characteristics have been collected and stored in a centralized, coded database. BCCs will be
ascertained by linkage with PALGA, the nationwide network and registry of histo- and cytopathology in
the Netherlands (ongoing), by clinical follow-up (ongoing), and by questionnaires sent out to the survivors
or their general practitioner (completed). A nested case-control study will be conducted. Cases (n≥100)
will include all cohort members who developed one or more BCCs. In early 2015, four controls per case
will be selected from the DCOG LATER cohort, matched on birth year, age at childhood cancer diagnosis,
and sex. Follow-up for controls must be at least as long as the interval between childhood cancer and BCC
in the corresponding case. The actually delivered dose to the location of the BCC (or matched location for
controls) will be estimated for each patient who had radiotherapy based on dose, field size, energy, and
other treatment parameters, using an in-house custom-designed dosimetry program, based on literature
sources, Monte Carlo simulations, and measurements in tissue-equivalent phantoms. The data will be
analyzed using conditional logistic regression, including linear excess odds models for evaluation of the
size and shape of the radiation dose-response. Results are expected in 2016.
1
basal cell carcinoma in childhood cancer survivors: a DCOG LATER study. Jop C. Teepen, MSc ; Flora E.
3
2
4
van Leeuwen, PhD ; Wim J.E. Tissing, MD PhD ; Marry M. van den Heuvel-Eibrink, MD PhD ; Eline van
5
7
6
Dulmen-den Broeder, PhD ; Birgitta Versluys, MD ; Dorine Bresters, MD PhD ; Jacqueline J. Loonen, MD
6
9
1
8
PhD ; Huib N. Caron, MD PhD ; Tamar E. Nijsten, MD PhD ; Marijke R. van Dijk, MD PhD ; DCOG LATER
11
11
10
11
Study Group (see appendix) ; Marilyn Stovall, PhD ; Rita E. Weathers, MS ; Susan A. Smith, MPH ;
1
1
Leontien C.M. Kremer, MD PhD ; and Cécile M. Ronckers, PhD ; Emma Children's Hospital / Academic
2
Medical Center, Amsterdam, Netherlands ; Netherlands Cancer Institute, Amsterdam, Netherlands ;
1
3
University Medical Center Groningen, Groningen, Netherlands ; Erasmus Medical Center / Sophia
4
Children’s Hospital, Rotterdam, Netherlands ; VU University Medical Center, Amsterdam, Netherlands ;
5
6
University Medical Center Utrecht, Utrecht, Netherlands ; Leiden University Medical Center, Leiden,
7
Netherlands ; Radboud University Medical Center, Nijmegen, Netherlands ; Erasmus Medical Center,
8
10
9
Rotterdam, Netherlands ; Dutch Childhood Oncology Group, Den Haag, Netherlands ; and The University
of Texas MD Anderson Cancer Center, Houston, TX 11
Introduction: Basal cell carcinoma (BCC) is the most common second malignancy among
childhood cancer survivors (CCS), in particular following radiotherapy. Despite low mortality rates, quality
of life is negatively impacted by a new cancer diagnosis as well as the associated cosmetic disfigurement
from surgical removal of (multiple) BCCs. More insight into the dose-effect relationship for radiotherapy
and BCC will identify subgroups at high and at low risk for BCC, thereby facilitating recommendations for
long-term CCS patient education and surveillance. Our aims are to evaluate the shape and magnitude of
the radiation dose-response relationship for BCC and to examine potential modifying factors such as sex,
age at exposure, childhood cancer type, chemotherapy, bone marrow transplant, skin type, and skin
pigmentation on the radiation dose-response for BCC. Methods: The DCOG LATER Study Group assembled
a nationwide cohort of 6,168 Dutch 5-year CCS diagnosed between 1963 and 2002. Detailed patient and
treatment characteristics have been collected and stored in a centralized, coded database. BCCs will be
ascertained by linkage with PALGA, the nationwide network and registry of histo- and cytopathology in
the Netherlands (ongoing), by clinical follow-up (ongoing), and by questionnaires sent out to the survivors
or their general practitioner (completed). A nested case-control study will be conducted. Cases (n≥100)
will include all cohort members who developed one or more BCCs. In early 2015, four controls per case
will be selected from the DCOG LATER cohort, matched on birth year, age at childhood cancer diagnosis,
and sex. Follow-up for controls must be at least as long as the interval between childhood cancer and BCC
in the corresponding case. The actually delivered dose to the location of the BCC (or matched location for
controls) will be estimated for each patient who had radiotherapy based on dose, field size, energy, and
other treatment parameters, using an in-house custom-designed dosimetry program, based on literature
sources, Monte Carlo simulations, and measurements in tissue-equivalent phantoms. The data will be
analyzed using conditional logistic regression, including linear excess odds models for evaluation of the
size and shape of the radiation dose-response. Results are expected in 2016.
