Author/Authors :
Keramatinia ، Aliasghar Department of Community Medicine - School of Medicine - Shahid Beheshti University of Medical Sciences , Mohseny ، Maryam Department of Community Medicine - School of Medicine - Shahid Beheshti University of Medical Sciences , Davoudi Monfared ، Esmat Department of Community Medicine - Health Management Research Center, Faculty of Medicine - Baqiyatallah University of Medical Sciences , Hosseini-Baharanchi ، Fatemeh Sadat Department of Biostatistics - School of Public Health - Iran University of Medical Sciences , Shahabi ، Fatemeh Department of Biostatistics - School of Public Health - Iran University of Medical Sciences , Safavi Naeini ، Nilofar Department of Medical Genetics - School of Medicine - Shahid Beheshti University of Medical Sciences , Kianpour Rad ، Sima Basil Hetzel Institute for Translational Health Research, Queen Elizabeth Hospital, Faculty of Health and Medical Sciences - University of Adelaide , Sheikhpour ، Mojgan Department of Mycobacteriology and Pulmonary Research - Microbiology Research Center (MRC) - Pasteur Institute of Iran , Beladian- Behbhan ، Ehsan Department of Community Medicine - School of Medicine - Shahid Beheshti University of Medical Sciences , Bahadorimonfared ، Ayad Department of Community Medicine - School of Medicine - Shahid Beheshti University of Medical Sciences , Aphsharpad ، Mandana Cancer Control Research Center, Cancer Control Foundation - Iran University of Medical Sciences , Movafagh ، Abolfazl Department of Medical Genetics - School of Medicine - Shahid Beheshti University of Medical Sciences
Abstract :
Background: The rate of childhood cancer death has dropped steadily over the past 50 years. The pediatric cancer risk has remained under investigation. Objectives: This study aims at investigating the associated factors with the survival of pediatric patients with retinoblastoma, sarcoma, brain tumor, and leukemia cancer. Methods: The cohort study of 1879 children with retinoblastoma, sarcoma, brain tumor, and leukemia aged 1, 1 - 5, 6 - 10, 11 - 15, and 15 years in Mahak Hospital and Rehabilitation Complex from 2007 to 2016 were enrolled in the study. Median survival time was reported for each cancer. Parametric survival models including Gompertz, Weibull, lognormal, and log-logistic models were fitted. Then, the model with almost minimum Akaike information criterion (AIC) was chosen. The hazard ratio (HR) and the analysis were performed by R3.5.1. Results: Totally, 270 (14.37%) patients with retinoblastoma, 667 (35.5%) with leukemia, 625 (33.26%) with a brain tumor, and 317 (16.87%) with sarcoma were included in this study; 815 (43.37%) patients were female. Gompertz’s model was chosen to fit the data due to the minimum AIC. The associated factors with the survival of childhood cancers were as follows: Age 1 year, parental relation, loco-regional relapse and chemotherapy alone (HR: 7.63, 1.56, 4.61, 1.12) in leukemia, other nationalities, metastasis or metastasis and loco-regional relapse and chemotherapy alone (HR = 3.74, 5.75, 2.12) in retinoblastoma, loco-regional relapse and metastasis (HR = 2.40, 3.71) in brain tumor, other ages except for 5 - 10 years, parental relation, chemotherapy alone, and metastasis (HR = 33.3, 1.80, 3.57, 3.8) in sarcoma. Conclusions: Age, parental familial relationships, combination therapy, and metastasis of primary cancer were the risk factors for survival of children with 4 common cancers of leukemia, retinoblastoma, brain tumors, and sarcoma, using the Gompertz model.
Keywords :
Cancer , Childhood , Parametric Survival Model , Gompertz Model , Retinoblastoma , Sarcoma , Brain Tumor , Leukemia
