Lorna Zadravec Zaletel1,2, Gregor Kos3. 1. Radiotherapy Department, Institute of Oncology Ljubljana, Zaloška 2, Ljubljana, Slovenia. lzaletel@onko-i.si. 2. Faculty of medicine, University of Ljubljana, Vrazov trg 2, Ljubljana, Slovenia. lzaletel@onko-i.si. 3. Radiotherapy Department, Institute of Oncology Ljubljana, Zaloška 2, Ljubljana, Slovenia.
Abstract
PURPOSE: To report on findings in screening colonoscopies in long-term survivors of childhood cancer treated with abdominopelvic irradiation (RT). METHODS: Screening colonoscopies were introduced at the Slovenian outpatient follow-up clinic in 2015, according to the Children's Oncology Group guidelines. In January 2019, 54 patients who received abdominopelvic irradiation for Hodgkin disease, Wilms tumour or dysgerminoma at the age of 0-16 between 1968 and 1995 were eligible for screening colonoscopy, and until December 2019, twenty-eight asymptomatic patients have undergone this examination. RESULTS: Patients were 1-16 (median 13) years old at cancer diagnosis and had colonoscopy 24-47 (median 36) years after diagnosis. They received abdominopelvic irradiation with the dose 16-46 (median 30) Gy. Adenomatous lesions were found in 18 patients (64%) and advanced adenomatous lesions in one-third. Patients who received abdominopelvic RT with a dose below 30 Gy had 75% incidence of adenomatous lesions and in those who received a dose of 30 Gy or more the incidence was 60%. Alkylating agents did not have impact on this incidence. CONCLUSIONS: In this first population-based study of screening colonoscopies in asymptomatic survivors of childhood cancer, we provided new evidence for 64% incidence of adenomatous lesions after abdominopelvic RT with the dose above or below 30 Gy. IMPLICATIONS FOR CANCER SURVIVORS: Screening colonoscopies are of vital importance in patients treated with abdominal RT in childhood.
PURPOSE: To report on findings in screening colonoscopies in long-term survivors of childhood cancer treated with abdominopelvic irradiation (RT). METHODS: Screening colonoscopies were introduced at the Slovenian outpatient follow-up clinic in 2015, according to the Children's Oncology Group guidelines. In January 2019, 54 patients who received abdominopelvic irradiation for Hodgkin disease, Wilms tumour or dysgerminoma at the age of 0-16 between 1968 and 1995 were eligible for screening colonoscopy, and until December 2019, twenty-eight asymptomatic patients have undergone this examination. RESULTS: Patients were 1-16 (median 13) years old at cancer diagnosis and had colonoscopy 24-47 (median 36) years after diagnosis. They received abdominopelvic irradiation with the dose 16-46 (median 30) Gy. Adenomatous lesions were found in 18 patients (64%) and advanced adenomatous lesions in one-third. Patients who received abdominopelvic RT with a dose below 30 Gy had 75% incidence of adenomatous lesions and in those who received a dose of 30 Gy or more the incidence was 60%. Alkylating agents did not have impact on this incidence. CONCLUSIONS: In this first population-based study of screening colonoscopies in asymptomatic survivors of childhood cancer, we provided new evidence for 64% incidence of adenomatous lesions after abdominopelvic RT with the dose above or below 30 Gy. IMPLICATIONS FOR CANCER SURVIVORS: Screening colonoscopies are of vital importance in patients treated with abdominal RT in childhood.
Authors: T R Möller; S Garwicz; L Barlow; J F Winther; E Glattre; G Olafsdottir; J H Olsen; R Perfekt; A Ritvanen; R Sankila; H Tulinius Journal: J Clin Oncol Date: 2001-07-01 Impact factor: 44.544
Authors: Raoul C Reulen; David L Winter; Clare Frobisher; Emma R Lancashire; Charles A Stiller; Meriel E Jenney; Roderick Skinner; Michael C Stevens; Michael M Hawkins Journal: JAMA Date: 2010-07-14 Impact factor: 56.272
Authors: J P Neglia; D L Friedman; Y Yasui; A C Mertens; S Hammond; M Stovall; S S Donaldson; A T Meadows; L L Robison Journal: J Natl Cancer Inst Date: 2001-04-18 Impact factor: 11.816