Comprehensive clinical follow-up of late effects in childhood cancer survivors shows the need for early and well-timed intervention

Ann Oncol. 2009 Jul;20(7):1170-7. doi: 10.1093/annonc/mdn778. Epub 2009 Mar 6.

Abstract

Background: Due to recent advances in treatment, nearly 80% of childhood cancer patients become long-term survivors. Studies on the late effects of survivors are under way worldwide. However, data on Asian survivors remain limited.

Methods: Data on 241 survivors at the Long-term Follow-up Clinic in Severance Hospital, South Korea, were collected and late effects were confirmed by oncologists.

Results: The median follow-up from diagnosis was 7.8 years. Late effects were identified in 59.8% of survivors and 23.2% had two or more late effects. Grade 3 or higher late effects were present in 10.8%. The most common late effects involved endocrine system (29.0%). Late effects were present in 95.7% of brain tumor survivors and 36.0% of Wilms' tumor survivors. Chemotherapy, hematopoietic stem-cell transplantation and radiotherapy were significant factors associated with the number and severity of late effects (P < 0.05). Brain tumor survivors had more severe late effects (P < 0.001), whereas Wilms' tumor survivors had fewer and milder late effects (P < 0.05).

Conclusion: The observation that over 50% of cancer survivors suffered from late effects during the short follow-up period and that a high frequency of endocrine late effects was present indicates the need for early and well-timed intervention of the survivors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Age of Onset
  • Antineoplastic Agents / adverse effects
  • Asian People
  • Child
  • Child, Preschool
  • Continuity of Patient Care
  • Endocrine System / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Korea
  • Male
  • Needs Assessment
  • Neoplasms / ethnology
  • Neoplasms / therapy*
  • Quality of Life / psychology*
  • Radiation Injuries
  • Risk
  • Survivors / psychology*
  • Time Factors
  • Young Adult

Substances

  • Antineoplastic Agents