Childhood Cancer Increases Risk of Recurrent Stroke

A retrospective analysis of data collected from over 14,000 childhood cancer survivors has found an increased risk of recurrent stroke decades after their first stroke. This risk is especially high in those who had been treated with cranial radiation, the study published in Neurology states.

The 14,358 survivors were less than 21 years of age at diagnosis and had survived at least 5 years subsequent to diagnosis. Enrolled in The Childhood Cancer Survivor Study, these patients, diagnosed primarily between 1970 and 1986, were prospectively followed till 1994. For the current study, the authors evaluated a cohort of 443 survivors who had suffered a stroke, 74% (329) of whom responded.

Two hundred and seventy one of the 329 confirmed a first stroke at a median age of 19 years (range 0-53 years) and 70 had a second stroke at a median age of 32 years (range 1-56 years). Cranial radiation therapy (≥50 Gy), hypertension, and an advanced age at first stroke were all identified by the authors as predictors of recurrent stroke. The 10-year cumulative incidence of late recurrent stroke was 21% (95% confidence interval (CI), 16%-27%) overall, and 33% (95% CI, 21%-44%) for those treated with ≥50 Gy of radiation, the authors found.

“We are at a point where more children are surviving cancer because of life-saving interventions. Now, we are facing long-term problems associated with these interventions,” said Sabine Mueller, MD, PhD, director of the UCSF Pediatric Brain Tumor Center in UCSF Benioff Children’s Hospital San Francisco and coauthor of the study.