Table A2.
SIRs for SMNs After 40 Years of Age for All Survivors and Cohort Members Treated With Previous Irradiation
| Characteristics | All Survivors Age ≥ 40 Years |
Cohort Members Treated With Previous Irradiation* |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No SN Before Age 40 Years |
SN Before Age 40 Years |
|||||||||||
| Observed | Expected | SIR (95% CI) | EAR | Observed | Expected | SIR, 95% CI | EAR | Observed | Expected | SIR, 95% CI | EAR | |
| All patients | 196 | 89.7 | 2.2 (1.9 to 2.5) | 1.31 | 119 | 47.9 | 2.5 (2.1 to 3.0) | 1.63 | 37 | 12.2 | 3.0 (2.2 to 4.2) | 2.39 |
| Sex | ||||||||||||
| Male | 54 | 38.1 | 1.4 (1.1 to 1.9) | 0.37 | 32 | 21.8 | 1.5 (1.0 to 2.1) | 0.42 | 12 | 3.1 | 3.9 (2.3 to 6.6) | 2.42 |
| Female | 142 | 51.6 | 2.8 (2.3 to 3.3) | 2.34 | 87 | 26 | 3.3 (2.7 to 4.1) | 3.16 | 25 | 9.1 | 2.7 (1.8 to 4.2) | 2.38 |
| Primary cancer diagnosis | ||||||||||||
| Leukemia | 23 | 14.6 | 1.6 (1.0 to 2.4) | 0.54 | 9 | 8.3 | 1.1 (0.6 to 2.1) | 0.08 | 4 | 2 | 2.0 (0.8 to 5.2) | 0.95 |
| CNS malignancy | 9 | 8.7 | 1.0 (0.5 to 2.1) | 0.03 | 5 | 4.6 | 1.1 (0.5 to 2.6) | 0.09 | 1 | 0.9 | 1.2 (0.2 to 8.0) | 0.14 |
| Hodgkin lymphoma | 112 | 30.7 | 3.6 (3.0 to 4.4) | 3.4 | 77 | 20 | 3.9 (3.1 to 4.8) | 3.64 | 27 | 7.2 | 3.8 (2.5 to 5.6) | 3.85 |
| Non-Hodgkin lymphoma | 13 | 8.5 | 1.5 (0.9 to 2.6) | 0.52 | 6 | 5.2 | 1.2 (0.5 to 2.5) | 0.16 | 3 | 0.8 | 3.8 (1.4 to 10.6) | 2.91 |
| Wilms tumor | 1 | 1.4 | 0.7 (0.1 to 5.1) | 0.21 | 1 | 1.1 | 1.0 (0.1 to 6.6) | 0.04 | 0 | |||
| Neuroblastoma | 0 | 0 | 0 | |||||||||
| Soft tissue sarcoma | 16 | 10.4 | 1.5 (0.9 to 2.8) | 0.62 | 13 | 4.5 | 2.9 (1.5 to 5.6) | 2.08 | 0 | |||
| Bone cancer | 22 | 14.7 | 1.5 (1.0 to 2.3) | 0.56 | 8 | 3.8 | 2.1 (1.0 to 4.4) | 1.23 | 2 | 0.7 | 3.0 (0.9 to 10.1) | 2.3 |
| Type of SMN | ||||||||||||
| Breast | 103 | 18.7 | 5.5 (4.5 to 6.7) | 1.04 | 68 | 9.5 | 7.2 (5.7 to 9.0) | 1.34 | 17 | 3.3 | 5.1 (3.1 to 8.4) | 1.32 |
| Thyroid | 12 | 6.3 | 1.9 (1.0 to 3.5) | 0.07 | 7 | 3.2 | 2.2 (0.9 to 5.0) | 0.09 | 5 | 1 | 5.2 (2.2 to 12.3) | 0.39 |
| Soft tissue sarcoma | 13 | 5.1 | 2.6 (1.5 to 4.4) | 0.1 | 6 | 2.8 | 2.1 (1.0 to 4.7) | 0.07 | 3 | 0.5 | 5.7 (1.8 to 17.4) | 0.24 |
| Osteosarcoma | 1 | 0.2 | 5.2 (0.7 to 36.7) | 0.01 | 0 | 1 | 0 | 42.1 (6.0 to 297.6) | 0.09 | |||
| CNS malignancy | 4 | 2.9 | 1.4 (0.5 to 3.7) | 0.01 | 3 | 1.6 | 1.9 (0.6 to 6.0) | 0.03 | 1 | 0.3 | 2.9 (0.4 to 20.5) | 0.06 |
| Lymphoma | 8 | 9.3 | 0.9 (0.4 to 1.9) | 0.02 | 4 | 5 | 0.8 (0.2 to 2.6) | 0.02 | 3 | 1.1 | 2.8 (0.9 to 8.5) | 0.18 |
| Melanoma | 9 | 8.9 | 1.0 (0.5 to 1.9) | 0 | 4 | 4.7 | 0.8 (0.3 to 2.3) | 0.02 | 0 | |||
| Leukemia | 3 | 2.6 | 1.2 (0.4 to 3.6) | 0.01 | 1 | 1.4 | 0.7 (0.1 to 5.1) | 0.01 | 0 | |||
| Lung | 5 | 3.7 | 1.3 (0.6 to 3.2) | 0.02 | 5 | 2.1 | 2.4 (1.0 to 5.9) | 0.07 | 0 | |||
| Female genitourinary | 6 | 7.9 | 0.8 (0.3 to 1.7) | 0.05 | 3 | 4 | 0.8 (0.3 to 2.3) | 0.05 | 0 | |||
| Head and neck | 5 | 2.7 | 1.8 (0.8 to 4.4) | 0.03 | 1 | 1.5 | 0.7 (0.1 to 4.7) | 0.01 | 2 | 0.3 | 6.7 (1.7 to 26.7) | 0.16 |
| Renal | 9 | 2.3 | 3.9 (2.0 to 7.5) | 0.08 | 5 | 1.3 | 3.9 (1.6 to 9.4) | 0.09 | 1 | 0.3 | 3.7 (0.5 to 26.1) | 0.07 |
| GI | 10 | 13.1 | 0.8 (0.4 to 1.4) | 0.04 | 6 | 7.2 | 0.8 (0.4 to 1.9) | 0.03 | 2 | 1.8 | 1.1 (0.3 to 4.4) | 0.02 |
| Other | 8 | 6 | 1.3 (0.6 to 2.9) | 0.02 | 6 | 3.5 | 1.7 (0.7 to 4.3) | 0.06 | 2 | 0.2 | 11.3 (2.9 to 44.0) | 0.18 |
| Treatment exposure | ||||||||||||
| Radiation therapy | 156 | 60.1 | 2.6 (2.2 to 3.1) | 1.78 | 119 | 47.9 | 2.5 (2.1 to 3.0) | 1.63 | 37 | 12.2 | 3.0 (2.2 to 4.2) | 2.39 |
| Alkylating agents | 95 | 40.5 | 2.4 (1.9 to 2.9) | 1.46 | 59 | 23.9 | 2.5 (1.9 to 3.2) | 1.57 | 19 | 6.1 | 3.1 (2.0 to 4.9) | 2.39 |
| Anthracyclines | 45 | 23.9 | 1.9 (1.4 to 2.6) | 0.92 | 27 | 10.9 | 2.5 (1.6 to 3.8) | 1.49 | 0 | |||
| Epipodophyllotoxins | 5 | 1.5 | 3.4 (1.5 to 8.0) | 2.22 | 4 | 0.9 | 4.6 (1.8 to 11.6) | 3.25 | 1 | 0.2 | 4.1 (0.6 to 28.6) | 2.88 |
| Platinum | 6 | 2 | 3.1 (1.4 to 6.7) | 1.98 | 2 | 0.4 | 4.9 (1.3 to 17.9) | 3.58 | 0 | |||
| Radiation, no chemotherapy | 59 | 20.2 | 2.9 (2.3 to 3.8) | 2.44 | 45 | 15.7 | 2.9 (2.2 to 3.8) | 2.3 | 14 | 4.4 | 3.2 (1.8 to 5.6) | 3 |
| Chemotherapy, no radiation | 22 | 15.1 | 1.5 (1.0 to 2.2) | 0.49 | 0 | 0 | ||||||
| Radiation and chemotherapy | 97 | 39.7 | 2.4 (2.0 to 3.0) | 1.51 | 74 | 32 | 2.3 (1.8 to 2.9) | 1.37 | 23 | 7.8 | 3.0 (2.0 to 4.5) | 2.12 |
Abbreviations: EAR, excess absolute risk per 1,000 person-years; SIR, standardized incidence ratio; SMN, subsequent malignant neoplasm; SN, subsequent neoplasm.
*
Total number of observed events in the with- and without-previous radiation groups = 186; for 10 SMNs, the radiation status of the individual was unknown.