Radiation dose as a risk factor for malignant melanoma following childhood cancer

S Guerin, A Dupuy, H Anderson, A Shamsaldin, G Svahn-Tapper, T Moller, E Quiniou, S Garwicz, Michael Hawkins, MF Avril, O Oberlin, J Chavaudra, F De Vathaire

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    48 Citations (Scopus)

    Abstract

    The aim of this study was to determine therapy-related risk factors for the development of melanoma after childhood cancer. Among 4401 3-year survivors of a childhood cancer in eight French and British centres and 25120 patients younger than 20 years old at first malignant neoplasm (FMN) extracted from the Nordic Cancer Registries, 16 patients developed a melanoma as a second malignant neoplasm (SMN). A cohort study of the French and British cohorts was performed. In a nested case-control study, the 16 patients who developed a melanoma as a SMN (cases) were matched with 3-5 controls in their respective cohort according to gender, age at the first cancer, the calendar year of occurrence of the first cancer and follow-up. Radiotherapy appeared to increase the risk of melanoma for local doses >15 Gy, Odds Ratio (OR)=13 (95% Confidence Interval (CI): 0.94-174). Regarding chemotherapy, we observed an increased OR for both alkylating agents and spindle inhibitors, OR=2.7 (95% CI: 0.5-14). Children treated for a gonadal tumour as a FMN were found to be at a higher risk of melanoma, OR=8.7 (95% CI: 0.9-86). The adjusted OR for the local radiation dose was 1.07 (95% CI: 1.00-1.15). In conclusion, radiotherapy may contribute to an increased risk of melanoma as a SMN, but only at very high doses of low linear energy transfer radiation. Common genetic origins between gonadal tumours and malignant melanomas are likely.
    Original languageEnglish
    Pages (from-to)2379-2386
    Number of pages8
    JournalEuropean Journal of Cancer
    Volume39
    DOIs
    Publication statusPublished - 1 Nov 2003

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