A retrospective cohort study has shown that pancreatic radiation is a risk factor for diabetes in survivors of paediatric cancer. This validates and refines prior epidemiological observations of diabetes after radiation to the abdomen and total-body irradiation, and will result in modification of surveillance recommendations in national survivor guidelines.
Key Points
Radiation to the tail of the pancreas increases risk of the development of diabetes in survivors of pediatric cancer and thus is a risk factor prompting the Children's Oncology Group to recommend routine screening of at risk patients using fasting glucose or haemoglobin A1c.
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References
Smith, M. A. et al. Outcomes for children and adolescents with cancer: challenges for the twenty-first century. J. Clin. Oncol. 28, 2625–2634 (2010).
Mariotto, A. B., Rowland, J. H., Ries, L. A., Scoppa, S. & Feuer, E. J. Multiple cancer prevalence: a growing challenge in long-term survivorship. Cancer Epidemiol. Biomarkers Prev. 16, 566–571 (2007).
Hewitt, M., Greenfield, S. & Stovall, E. (Eds) From Cancer Patient to Cancer Survivor: Lost in Transition. (American Society of Clinical Oncology and Institute of Medicine, Washington, DC, 2006).
National Coalition for Cancer Survivorship and Institute of Medicine. Implementing Cancer Survivorship Care Planning. (Institute of Medicine, Washington, DC, 2007).
Landier, W., Wallace, W. H. & Hudson, M. M. Long-term follow-up of pediatric cancer survivors: education, surveillance, and screening. Pediatr. Blood Cancer 46, 149–158 (2006).
Oeffinger, K. C. et al. Chronic health conditions in adult survivors of childhood cancer. N. Engl. J. Med. 355, 1572–1582 (2006).
Teinturier, C. et al. Diabetes mellitus after abdominal radiation therapy. Lancet 346, 633–634 (1995).
Meacham, L. R. et al. Diabetes mellitus in long-term survivors of childhood cancer. Increased risk associated with radiation therapy: a report for the childhood cancer survivor study. Arch. Intern. Med. 169, 1381–1388 (2009).
de Vathaire, F. et al. Radiation dose to the pancreas and risk of diabetes mellitus in childhood cancer survivors: a retrospective cohort study. Lancet Oncol. 13, 1002–1010 (2012).
Zhang, Y., Hu, G., Yuan, Z. & Chen, L. Glycosylated hemoglobin in relationship to cardiovascular outcomes and death in patients with type 2 diabetes: a systematic review and meta-analysis. PLoS ONE 7, e42551 (2012).
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Meacham, L., Dilley, K. Diabetes risk after radiation—not out of the woods. Nat Rev Clin Oncol 9, 618–619 (2012). https://doi.org/10.1038/nrclinonc.2012.184
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DOI: https://doi.org/10.1038/nrclinonc.2012.184
