TABLE 2.
Second solid malignant neoplasms
| Primary Diagnosis | Chemotherapy | Age at IMRT (years) | IMRT Field | Adjusted prescription dose to IMRT site/Dose at site of SMN (Gy [BED3]) | SMN Diagnosis | Isodose level at SMN site (%) | Time from IMRT to SMN (years) | Vital Status |
|---|---|---|---|---|---|---|---|---|
| Medulloblastomaa | CDDP, CCNU, VCR, TP, EPEG, TMZ | 10.2 | Posterior fossa | 55.8/55.8 [89.3] | High grade glioma | 100% | 7.6 | Deceased |
| Rhabdomyosarcomaa | CP, IFO, VCR, DXR, EPEG | 3.5 | Nasopharynx | 50.4/50.4 [80.6] | Sarcomab | 100% | 6.9 | Deceased |
| Undifferentiated thyroid cancera | DXR, EPEG | 15.7 | Neck | 57.6/60.0 [92.0] | Osteosarcoma | 100% | 9.6 | Deceased |
| High-grade spindle sarcomaa, e | DXR, IFO | 13.0 | Orbit | 96.4 (50.4 IMRT, 46.0 CRT)/96.4 [157.3] | Osteosarcoma | 100% | 7.3 | Deceased |
| Medulloblastoma | CDDP, VCR, EPEG, CP, CBDCA, TSPA | 3.2 | Posterior fossa | 54.0/28.8 (PA field from CSI) [46.1] | Colon adenocarcinoma | 80% (PA field for CSI) | 20.5 | Deceased |
| Undifferentiated sarcoma | CP, VCR, DXR, IFO, EPEG, MTX (IT, IV), ARA-C, CDDP, pegaspargase, fludarabine, L-PAM | 11.4 | Pelvis and para-aortic lymph nodes | 36.0/15.0 [24.0] | Colon adenocarcinoma | 40% | 16.4 | Deceased |
| Neuroblastoma | CP, CDDP, DXR, VCR, EPEG | 2.8 | Right skull | 21.0/0.0 [0.0] | Papillary thyroid cancer | Out-of-field | 16.7 | Alive, NED |
| Acute lymphoblastic leukemia | VCR, L-ASP, MTX (IT, IV, PO), ARA-C (SQ, IV, IT), CP, 6-MP, 6-TG,DNR, DXR | 9.7 | Arachnoid cyst | 24.0 (18.0 CRT, 6.0 IMRT)/20.0 [30.0] | High grade glioma | 80% | 16.5 | Alive, on treatment |
| Squamous cell carcinoma | None | 20.4 | Oral cavity and neck | 66.6/NAc | Unknown primary, widespread osseous metastases | NAc | 15.0 | Deceased |
| Retinoblastomae | VCR, CBDCA, VP16, DXR, CP, TP, IFO | 6.8 | Left orbit | 90.0 (45.0 IMRT, 45.0 CRT) d/45.0 [72.0] | Osteosarcoma | 100% | 11.8 | Alive, NED |
| Retinoblastoma | L-PAM (IA), CDDP, VCR, CP, EPEG, CBDCA, TSPA | 9.1 | Right orbit and sphenoid | 36.0/18.0 [28.8] | High grade glioma | 50% | 8.3 | Deceased |
Included in the original manuscript by Casey et al. published in 2015
Presumed, biopsy was not performed
Widespread metastases from cancer of unknown primary, cannot be categorized nor attributable to IMRT
Prior conventional RT was delivered at outside institution to bilateral orbits previously at age of 2 months
Hereditary retinoblastoma
Abbreviations: CDDP, cisplatin; CCNU, lomustine; VCR, vincristine; EPEG, etoposide; TMZ, temozolomide; CP, cyclophosphamide; IFO, ifosfamide; DNR, daunorubicin; DXR, doxorubicin; MTX, methotrexate; L-PAM, melphalan; L-ASP, asparaginase; CBDCA, carboplatin; ARA-C, cytarabine; 6-TG, thioguanine; 6-MP, mercaptopurine; TSPA, thiotepa; TP, topotecan; IT, intrathecal; IV, intravenous; PO, oral administration; SQ, subcutaneous; IA, intra-arterial; NA, not-applicable; NED, no evidence of disease; BED3, biologically effective dose assuming α/β ratio of 3