Table 3.
Risk of bone sarcoma according to the type of first cancer
| No. of cases/no. of patients | Radiation therapy (%) | Average bone dose (Gy), mean, median (range)a | AER per 105 PYR (95 % CI) | SIRb (95 % CI) | Unadjusted HR (95 % CI) | |
|---|---|---|---|---|---|---|
| Nephroblastoma | 2/851 | 72.7 | 6.6, 5.7 (0.1–24.5) | 7.6 (−0.8 to 20.3) | 10.5 (0.0–26.3) | 1 (Ref) |
| Neuroblastoma | 2/573 | 55.2 | 5.1, 4.0 (0.1–29.1) | 12.6 (−0.8 to 32.7) | 16.7 (0.0–41.7) | 1.6 (0.2–11.5) |
| Hodgkin’s disease | 5/378 | 91.3 | 13.0, 12.6 (0.0–40.0) | 51.2 (9.6–103.2) | 62.5 (12.5–125.0) | 6.2 (1.2–31.5) |
| Non-Hodgkin lymphoma | 3/459 | 59.5 | 5.8, 4.8 (0.1–25.0) | 27.1 (−0.8 to 64.3) | 33.3 (0.0–77.8) | 3.1 (0.5–18.4) |
| Soft tissue sarcoma | 11/535 | 62.6 | 3.2, 1.9 (0.0–17.4) | 76.6 (34.4–125.8) | 100.0 (45.5–163.6) | 9.3 (2.0–41.8) |
| Ewing’s sarcoma | 6/141 | 92.2 | 3.8, 2.7 (0.0–16.8) | 179.5 (59.2–329.7) | 200.0 (66.7–366.7) | 20.1 (4.1–98.8) |
| CNS tumor | 1/690 | 83.0 | 8.0, 3.7 (0.3–35.0) | 4.6 (−0.7 to 15.3) | 7.1 (0.0–21.4) | 0.6 (0.1–6.9) |
| Gonadal tumor | 1/227 | 38.3 | 7.9, 7.6 (0.5–28.8) | 16.7 (−0.7 to 51.5) | 25.0 (0.0–75.0) | 2.1 (0.2–22.7) |
| Retinoblastoma | 7/144 | 81.3 | 1.8, 1.2 (0.1–26.3) | 220.4 (62.3–410.0) | 233.3 (66.7–433.3) | 25.0 (5.2–120.9) |
| Other first cancers | 1/173 | 48.6 | 7.5, 6.4 (0.2–28.7) | 21.5 (−0.7 to 65.9) | 33.3 (0.0–100.0) | 2.7 (0.2–29.4) |
| Entire cohort | 39/4,171 | 69.0 | 6.8, 4.7 (0.0–40.0) | 35.1 (24.0–47.1 | 44.8 (31.0–59.8) | – |
PYR person-years, CI confidence interval, HR hazard ratio in a Cox’s proportional hazards model with clustering in order to take into account the fact that several bones are from the same patients
aIn patients with radiotherapy, except for those treated by brachytherapy
bAs compared to the general British population: AER absolute excess risk, defined as [(obs − exp)/person-years], SIR standardized incidence ratio, defined as (obs/exp)