Bottom Line: Adult survivors of childhood abdominal and pelvic cancers who had been treated with radiation therapy experienced abnormalities in body composition and had worse cardiometabolic health compared with the general population.

Journal in Which the Study was Published: Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research

Author: Carmen Wilson, PhD, assistant member in the Epidemiology and Cancer Control department at St. Jude Children's Research Hospital

Background: "Body composition abnormalities and cardiometabolic impairments are of concern among survivors given that in the general population, these conditions increase the risk of developing life-threatening diseases including cardiovascular disease and type 2 diabetes," said Wilson. The impacts of radiation therapy on metabolic health have been previously reported for survivors of pediatric leukemia, brain tumors, and hematopoietic stem cell transplants, but the impacts on survivors of pediatric abdominal and pelvic tumors remained unclear, she said.

How the Study was Conducted: In this study, Wilson and colleagues assessed 431 adult survivors of pediatric abdominal or pelvic solid tumors who had been previously treated at St. Jude Children's Research Hospital. The median age of participants during the study was 29.9 years. The most frequent childhood diagnoses were neuroblastoma, Wilms tumor, and germ cell tumor, and the median age of participants at diagnosis was 3.6 years. Approximately 37 and 36 percent of participants had received abdominal and pelvic radiation therapy, respectively, as part of their treatment.

To assess the impacts of radiation therapy, the authors compared the participants' body composition, metabolic abnormalities, and physical function to those of the general population, using age-, sex-, and ethnicity-matched data from the 2013 to 2014 National Health and Nutrition Examination Survey (NHANES).

Results: Wilson and colleagues found that compared with data from NHANES, the survivors in their study were significantly more likely to have insulin resistance (33.8 percent vs. 40.6 percent), high triglycerides (10.02 percent vs. 18.4 percent), and low levels of high-density lipoproteins, commonly referred to as "good cholesterol" (28.9 percent vs. 33.5 percent). There were no significant differences in the levels of low-density lipoproteins ("bad cholesterol") between survivors and the general population.

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