International Study of Subsequent Colorectal Cancer Among Survivors of Childhood, Adolescent, and Young Adult Cancers (I-SCRY)

儿童、青少年和年轻成人癌症幸存者后续结直肠癌的国际研究 (I-SCRY)

• 批准号: 10569105
• 负责人: Tara Olive Henderson
• 金额: $ 35.44万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-08 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10569105
• 关键词: Abdomen; Address; Adolescent and Young Adult; Aftercare; Age; Alkylating Agents; Anthracycline; Attention; Biology; Body mass index; Cancer Survivor; Chemotherapy and/or radiation; Childhood; Cisplatin; Clinical; Cohort Studies; Colonoscopy; Colorectal Cancer; Cost Effectiveness Analysis; Country; Data; Development; Dose; Ensure; Exposure to; Future; General Population; Genetic; Guidelines; Incidence; Individual; International; Investigator-Initiated Research; Knowledge; Life Style; Long-Term Survivors; Malignant Childhood Neoplasm; Malignant Neoplasms; Morbidity - disease rate; Neoplasms; Outcome; Participant; Pediatric Oncology Group; Pelvis; Physical activity; Population; Premature Mortality; Prevention; Procarbazine; Prognosis; Radiation; Radiation Dose Unit; Radiation exposure; Radiation therapy; Resources; Risk; Risk Factors; Role; Standardization; Survivors; Time; Work; cancer diagnosis; cancer therapy; chemotherapy; childhood cancer survivor; cohort; colorectal cancer prevention; colorectal cancer risk; common treatment; cost effectiveness; evidence base; follow-up; high risk; mortality; novel; prevent; screening; screening guidelines; sex; young adult

PROJECT SUMMARY / ABSTRACT Survivors of childhood, adolescent, and young adult (AYA) cancer have an elevated risk of subsequent malignant neoplasms which are associated with morbidity and premature mortality. Emerging evidence suggests that colorectal cancer (CRC), associated with abdominal or pelvic radiotherapy used to treat the childhood or AYA cancer, is one such neoplasm. Early studies indicate other treatment exposures, including cisplatin and alkylator therapy, may also be associated with CRC risk and may interact with the radiotherapy to confer a markedly elevated risk. Knowledge of whether age at exposure to these therapies might modify risk is limited. Further, prognosis after a treatment-related CRC is not well-understood. These gaps in knowledge are due to the limited number of CRCs in any single cohort, lack of detailed information on primary cancer treatments for some cohorts, the relatively young age of cohorts, and the focus of existing cohorts on either childhood cancer survivors or on survivors of specific young adult cancers. We propose to leverage the unique resources of eight international childhood and AYA cancer survivor cohorts. We will pool individual participant data on 51,309 survivors, 298 with CRC, and with median follow-up across studies ranging from 13 to 26 years after primary cancer diagnosis, to comprehensively examine risk factors of, and mortality after, subsequent CRCs. This is almost four-fold the number of CRCs in any known childhood or AYA cohort with detailed treatment data available. Thus, the combination of childhood and AYA cancer survivors into a single cohort is novel and given common treatment approaches to pediatric and AYA cancer, will enable us to address these questions with the ability to assess the role of age at exposure. The primary aim of this project is to evaluate the association of childhood and AYA cancer therapy (abdominal and/or pelvic radiation fields and dose, as well as chemotherapy exposures including cumulative doses of alkylating agents, anthracyclines, platinating agents) on CRC risk in a large, multi-cohort, international survivor population. Secondary aims will focus on conducting an expanded assessment of the burden of CRC in childhood and AYA cancer survivors. This includes estimating and comparing the incidence of CRC in childhood and AYA cancer survivors to the incidence of CRC in the general population, as well as characterizing mortality following a CRC diagnosis in childhood and AYA cancer survivors and comparing it to that observed following a de novo CRC diagnosis in the general population. The results from this work have the potential to help refine screening guidelines and strategies for preventing CRC. In addition, in achieving our aims, we will establish a resource that may be leveraged for future investigator-initiated research.

项目摘要 /摘要 童年，青少年和年轻人（aya）癌症的幸存者的风险较高 与发病率和过早死亡有关的恶性肿瘤。新兴证据 表明与治疗腹部或骨盆放射疗法相关的结直肠癌（CRC） 儿童或艾雅癌就是一种这种肿瘤。早期研究表明其他治疗暴露，包括 顺铂和烷基疗法也可能与CRC风险有关，并可能与放射疗法相互作用 赋予风险明显升高。了解暴露于这些疗法时可能会改变风险的年龄是 有限的。此外，与治疗相关的CRC后的预后没有得到很好的理解。这些知识中的差距是 由于任何单一队列中的CRC数量有限，因此缺乏有关原发性癌症的详细信息 一些队列的治疗，相对年轻的同类年龄以及现有队列的重点 儿童癌症幸存者或特定年轻成人癌的幸存者。 我们建议利用八个国际童年和AYA癌症幸存者的独特资源 同伙。我们将汇总51,309个幸存者的个人参与者数据，298个带有CRC的数据和中位随访 在原发性癌症诊断后的13至26年的研究中，全面检查风险 随后的CRC的因素和死亡率。这几乎是任何已知的CRC数量的四倍 童年或AYA队列，提供详细的治疗数据。因此，童年和aya的结合 癌症幸存者进入一个队列是新颖的，并给出了儿科和AYA的常见治疗方法 癌症，将使我们能够以评估年龄在接触年龄的作用的能力来解决这些问题。 该项目的主要目的是评估儿童和AYA癌症治疗的关联 （腹部和/或骨盆辐射场和剂量，以及化学疗法暴露，包括累积 烷基化剂，蒽环类药物，粉末状剂）在大型，多体，国际的CRC风险上 幸存者人口。次要目标将重点进行扩大的CRC负担评估 在童年和艾雅癌幸存者。这包括估计和比较CRC的发生率 儿童和AYA癌症幸存者在普通人群中发生CRC的发病率，以及 在儿童期和AYA癌症幸存者的CRC诊断后表征死亡率，并将其比较 在普通人群中从头诊断后观察到的。 这项工作的结果有可能帮助完善筛选指南和策略 防止CRC。此外，在实现我们的目标时，我们将建立一种可能利用的资源 未来研究者发起的研究。