Can radiotherapy near the spleen lead to severe infections later in life?

The long-term side effects of receiving radiotherapy to the spleen are poorly understood. Having a spleen that doesn’t function fully, or no spleen at all, can put patients at high risk of severe infection. Without appropriate antibiotics there is a high risk of death in these patients. Because of this, a high dose of radiotherapy near the spleen is thought to increase the risk of severe infection and death. However, more evidence is required, especially in childhood cancer survivors.  

The aim of this study is to find out how at risk of severe infection survivors of childhood cancer are. The research team, led by Dr Henry Mandeville, will be studying the risk of severe infection in survivors who were treated with radiotherapy which may have affected their spleen. Once this risk is outlined, appropriate guidance can be given to clinicians and patients to reduce the risk of severe infection.  

This study will examine hospital admissions and deaths from severe infection in survivors of Wilms’ tumour (a childhood kidney cancer). Patients receiving radiotherapy to their left kidney will have also received a similar dose of radiotherapy to their spleen, as they are very close to each other. Infection-related deaths and admissions in this group will be compared to those patients who did not have radiotherapy near the spleen. Detailed radiotherapy doses have been calculated for another group of patients who have different tumour types. The researchers will also look at the radiotherapy dose received by the spleen to see if the dose influences infections rates and deaths later in life.