儿童癌症幸存者的颈动脉超声筛查的患病率：儿童癌症幸存者研究的报告
Prevalence of carotid ultrasound screening in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study
影响因子:5.10000
分区:医学1区 Top / 肿瘤学2区
发表日期:2025 Jan 01
作者:
Yolanda Bryce, Jillian A Whitton, Kayla L Stratton, Wendy M Leisenring, Eric J Chow, Gregory Armstrong, Brent Weil, Bryan Dieffenbach, Rebecca M Howell, Kevin C Oeffinger, Paul C Nathan, Emily S Tonorezos
摘要
许多儿童癌症幸存者有心血管疾病和中风的风险。北美儿童肿瘤学组长期随访指南建议在颈部放射治疗（RT）≥40Gy后10年癌症幸存者中的颈动脉超声检查。尚未描述在该人群中使用颈动脉超声检查。诊断为1970- 1999年的儿童癌症（n = 8693）和兄弟姐妹（n = 1989）（n = 1989），询问了儿童癌症幸存者研究的研究是否曾经曾经患有颈动脉超声。评估了颈动脉超声的患病率。在多变量泊松回归模型中评估了患病率（PR）和95％置信区间（CI）。在没有报告的心血管状况的参与者中，RT≥40Gy的幸存者在颈部（n = 172）的幸存者中的患病率（n = 172）为29.7％（95％CI，22.5-36.5-36.8），<40 gy（<40 gy），<<40 gyty（<40 gy），<<40 gy <22.5-36.8）； 10.7％； 95％CI，9.9％-11.4％）。没有心血管疾病的兄弟姐妹（n = 1621）的颈动脉超声患病率最低（4.7％； 95％CI，3.6％-5.7％）。 In a multivariable models among survivors with no reported cardiovascular condition and RT ≥40 Gy to the neck, those who were over age 50 (vs. 18-49) at follow-up (PR = 1.82; 95% CI, 1.09-3.05), with a history of seeing a cancer specialist in the last 2 years (PR = 2.58; 95% CI, 1.53-4.33), or having a colonoscopy （PR = 2.02; 95％CI，1.17-3.48）或超声心动图（PR = 6.42; 95％CI，1.54-26.85）更有可能患有颈动脉超声波。许多幸存者尽管符合现有的指南，但仍未经过颈动脉超声。医疗保健提供的功能，例如看过癌症专家或进行其他测试是相关的。
Abstract
Many childhood cancer survivors are at risk for cardiovascular disease and stroke. The North American Children's Oncology Group long-term follow-up guidelines recommend carotid ultrasound in cancer survivors 10 years after neck radiation therapy (RT) ≥40 Gy. The use of carotid ultrasound in this population has not been described.Survivors of childhood cancer diagnosed 1970-1999 (N = 8693) and siblings (N = 1989) enrolled in the Childhood Cancer Survivor Study were asked if they had ever had a carotid ultrasound. Prevalence of carotid ultrasound was evaluated. Prevalence ratios (PR) and 95% confidence intervals (CIs) were evaluated in multivariate Poisson regression models.Among participants with no reported cardiovascular condition, prevalence of carotid ultrasound among survivors with RT ≥40 Gy to the neck (N = 172) was 29.7% (95% CI, 22.5-36.8), significantly higher than those with <40 Gy (prevalence 10.7%; 95% CI, 9.9%-11.4%). Siblings without a cardiovascular condition (N = 1621) had the lowest prevalence of carotid ultrasound (4.7%; 95% CI, 3.6%-5.7%). In a multivariable models among survivors with no reported cardiovascular condition and RT ≥40 Gy to the neck, those who were over age 50 (vs. 18-49) at follow-up (PR = 1.82; 95% CI, 1.09-3.05), with a history of seeing a cancer specialist in the last 2 years (PR = 2.58; 95% CI, 1.53-4.33), or having a colonoscopy (PR = 2.02; 95% CI, 1.17-3.48) or echocardiogram (PR = 6.42; 95% CI, 1.54-26.85) were more likely to have had a carotid ultrasound.Many survivors do not undergo carotid ultrasound despite meeting existing guidelines. Health care delivery features such as having seen a cancer specialist or having other testing are relevant.