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A retrospective cohort study evaluated patients under 18 treated with RT for primary cancer at Children’s Cancer Hospital, Cairo, from 2009–2015, followed through 2021. Fine and Gray cumulative incidence estimated SMN overall and in-field events; Wilcoxon comparisons assessed timing by RT field and alkylating versus non-alkylating CT. Among 3,132 patients, 23 developed SMNs, including 8 within the prior RT field, with longer time to SMN for in-field cases.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/incidence-of-second-malignancies-among-children-treated-for-cancer-with-radiotherapy-in-egypt/351686/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/incidence-of-second-malignancies-among-children-treated-for-cancer-with-radiotherapy-in-egypt/351686.png","ImageObject",300,407,{"name":92,"@type":93},"Adam","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-23","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":8},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What late effects and risk factors are the study focused on?","Question",{"text":112,"@type":113},"The study focuses on secondary malignant neoplasms (SMNs) as serious late effects after childhood cancer treatment. It considers radiotherapy (RT) and chemotherapy (CT) as potential causes of SMNs.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was SMN incidence analyzed in the retrospective cohort?",{"text":117,"@type":113},"Patients under 18 treated with RT between 2009 and 2015 were followed through 2021. Cumulative incidence for SMN overall and in-field SMNs was estimated using the Fine and Gray method.",{"name":119,"@type":110,"acceptedAnswer":120},"What did the study find about the timing and location of SMNs relative to RT fields?",{"text":121,"@type":113},"Eight of 23 SMNs arose within the prior RT field. Median time to SMN was longer for in-field than out-of-field cases, and there was no significant difference in time to SMN by CT type.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},351686,1790160154,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":8,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},1374404737137,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Cancer Reports   \n ORIGINAL ARTICLE  OPEN ACCESS   \nIncidence of Second Malignancies Among Children Treated for Cancer With Radiotherapy in Egypt  \nCharlotte L. Sackett1 | Mohamed S. Zaghloul2  | Ahmed Aldesouky3 | Alaa Elhaddad4 | Li Zhang5 | Chloe A. Teasdale6  | Amr S. Soliman5  \n1Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, California, Los Angeles,  \nUSA | 2Department of Radiation Oncology, National Cancer Institute, Cairo University & Children's Cancer Hospital, Cairo, Egypt | 3Department of Radiation Oncology, Children's Cancer Hospital, Cairo, Egypt | 4Department of Pediatric Oncology, National Cancer Institute, Cairo University & Children's Cancer Hospital, Cairo, Egypt | 5Community Health and Social Medicine Department, CUNY School of Medicine, The City College of New York, New York, New York, USA | 6Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, New York, USA  \nCorrespondence: Mohamed S. Zaghloul ([mszagh@yahoo.com](mszagh@yahoo.com))  \nReceived: 26 August 2025 | Revised: 25 March 2026 | Accepted: 6 April 2026  \nKeywords: chemotherapy | Egypt | LMIC | oncology | pediatric cancer | radiation | radiotherapy | secondary cancer | secondary malignancy | SMN  \nABSTRACT  \nBackground: Survivors of childhood cancer (CCS) are at risk for secondary malignant neoplasms (SMNs): serious late effects of treatment. Radiotherapy (RT) and chemotherapy (CT) are possible causes of SMNs.  \nAims: To measure SMN incidence and characteristics among Egyptian CCS treated with RT, and to compare SMN timing and location based on RT field and CT type.  \nMethods and Results: We performed a retrospective cohort study of patients under 18 years who received radiotherapy for primary cancer at the Children's Cancer Hospital, Cairo, Egypt, from 2009 to 2015, with follow-up through 2021. We calculated cumulative incidence functions for second malignant neoplasm (SMN) development overall and by primary diagnosis, using the Fine and Gray method, both for all SMNs and for in-field SMNs. We used the Wilcoxon rank-sum test to compare time to SMN between patients with in-field versus out-of-field SMNs and those who received alkylating versus non-alkylating chemotherapy. Of 3132 patients (60.1% male; median age 6.2 years), 23 developed an SMN (11.1-year cumulative incidence: 1.85%, 95% CI: 0.84%– 3.57%). Eight (34.8%) of the 23 SMNs arose within the prior RT field (11-year cumulative incidence: 2.71%, 95% CI: 1.32%–4.93%) . Median time to SMN was longer for in-field than out-of-field cases (7.9, IQR: 6.0–9.9 vs. 4.3years, IQR: 2.7–5.6; p = 0.002) . There was no significant difference in time to SMN by CT type.  \nConclusion: SMN incidence in this cohort matched rates in high-income countries. Strong long-term follow-up is essential for CCS in Egypt and similar settings.  \n1 | Introduction  \nCancer is a leading cause of morbidity and mortality for children globally [1] . In 2022, the International Agency for Research on Cancer reported that 275 000 children aged 0–19 were diagnosed  \nwith cancer, and more than 100 000 died [2] . Advances in treatment have markedly improved survivorship for children with cancer in high-income countries, with the United States reporting an increase in overall 5-year survival from 10% to 85% over the past four decades [3, 4] .  \n\n| The views expressed in the submitted article are the views of the authors and not an official position of the institution or funder. |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.\u003Cbr>© 2026 The Author(s). Cancer Reports published by Wiley Periodicals LLC. |\n\nCancer Reports, 2026; 9:e70542 1 of 10  \n[https://doi.org/10.1002/cnr2.70542](https://doi.org/10.1002/cnr2.70542)  \nDespi","cbCaifMKf1kX5Qoe","https://ap.wps.com/l/cbCaifMKf1kX5Qoe","pdf",673017,"English","# Abstract\n## Background\n## Aims\n## Methods and Results\n## Conclusion\n# Introduction","[{\"question\":\"What late effects and risk factors are the study focused on?\",\"answer\":\"The study focuses on secondary malignant neoplasms (SMNs) as serious late effects after childhood cancer treatment. It considers radiotherapy (RT) and chemotherapy (CT) as potential causes of SMNs.\"},{\"question\":\"How was SMN incidence analyzed in the retrospective cohort?\",\"answer\":\"Patients under 18 treated with RT between 2009 and 2015 were followed through 2021. Cumulative incidence for SMN overall and in-field SMNs was estimated using the Fine and Gray method.\"},{\"question\":\"What did the study find about the timing and location of SMNs relative to RT fields?\",\"answer\":\"Eight of 23 SMNs arose within the prior RT field. Median time to SMN was longer for in-field than out-of-field cases, and there was no significant difference in time to SMN by CT type.\"}]","Incidence of Second Malignancies Among Children Treated for Cancer With Radiotherapy in Egypt | PDF",1790095322,25]