{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T15:02:45Z","timestamp":1779894165056,"version":"3.53.1"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R25 CA112383"],"award-info":[{"award-number":["R25 CA112383"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      We performed a retrospective cohort study of patients under 18\u2009years who received radiotherapy for primary cancer at the Children's Cancer Hospital, Cairo, Egypt, from 2009 to 2015, with follow\u2010up 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\u2010field SMNs. We used the Wilcoxon rank\u2010sum test to compare time to SMN between patients with in\u2010field versus out\u2010of\u2010field SMNs and those who received alkylating versus non\u2010alkylating chemotherapy. Of 3132 patients (60.1% male; median age 6.2\u2009years), 23 developed an SMN (11.1\u2010year cumulative incidence: 1.85%, 95% CI: 0.84%\u20133.57%). Eight (34.8%) of the 23 SMNs arose within the prior RT field (11\u2010year cumulative incidence: 2.71%, 95% CI: 1.32%\u20134.93%). Median time to SMN was longer for in\u2010field than out\u2010of\u2010field cases (7.9, IQR: 6.0\u20139.9 vs. 4.3\u2009years, IQR: 2.7\u20135.6;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). There was no significant difference in time to SMN by CT type.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SMN incidence in this cohort matched rates in high\u2010income countries. Strong long\u2010term follow\u2010up is essential for CCS in Egypt and similar settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.70542","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T02:45:41Z","timestamp":1779158741000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence of Second Malignancies Among Children Treated for Cancer With Radiotherapy in Egypt"],"prefix":"10.1002","volume":"9","author":[{"given":"Charlotte L.","family":"Sackett","sequence":"first","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine University of Southern California  California Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1999-6528","authenticated-orcid":false,"given":"Mohamed S.","family":"Zaghloul","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Institute Cairo University &amp; Children's Cancer Hospital  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Aldesouky","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Children's Cancer Hospital  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Elhaddad","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, National Cancer Institute Cairo University &amp; Children's Cancer Hospital  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[{"name":"Community Health and Social Medicine Department, CUNY School of Medicine The City College of New York  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9165-8972","authenticated-orcid":false,"given":"Chloe A.","family":"Teasdale","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy City University of New York (CUNY)  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr S.","family":"Soliman","sequence":"additional","affiliation":[{"name":"Community Health and Social Medicine Department, CUNY School of Medicine The City College of New York  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2214\u2010109x(21)00566\u20100"},{"key":"e_1_2_12_3_1","unstructured":"Childhood cancer World Health Organization accessed May 3 2024 https:\/\/www.iarc.who.int\/cancer\u2010type\/childhood\u2010cancer\/#:~:text=In%202022%2C%20more%20than%20275 cancer%20is%20difficult%20to%20diagnose."},{"key":"e_1_2_12_4_1","volume-title":"Cancer Statistics Review, 1975\u20132003","author":"SEER","year":"2006"},{"key":"e_1_2_12_5_1","volume-title":"Cancer Statistics Review (CSR) 1975\u20132018","author":"SEER","year":"2021"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.16875"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(22)02471\u20100"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2020.101779"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(24)00355\u20103"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.21037\/amj\u201020\u2010179"},{"key":"e_1_2_12_11_1","unstructured":"Radiation Therapy United States Environmental Protection Agency accessed May 3 2024 https:\/\/www.epa.gov\/radtown\/radiation\u2010therapy#:~:text=Radiation%20therapy%20uses%20ionizing%20radiation destroying%20their%20ability%20to%20divide."},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.09.058"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1158\/2643\u20103230.BCD\u201024\u20100103"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.00129"},{"key":"e_1_2_12_15_1","unstructured":"2020 Annual Report Children's Cancer Hospital Foundation \u2010 Egypt accessed April 30 2024 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