Increasing and Worsening Late Effects in Childhood Cancer Survivors during Follow-up.
10.3346/jkms.2013.28.5.755
- Author:
Jung Woo HAN
1
;
Hyo Sun KIM
;
Beom Sik KIM
;
Seung Yeon KWON
;
Yoon Jung SHIN
;
Sun Hee KIM
;
Jong Hee KO
;
Chuhl Joo LYU
Author Information
1. Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University Health System, Seoul, Korea. cj@yuhs.ac
- Publication Type:Original Article
- Keywords:
Complications;
Health;
Late Effects;
Morbidity;
Neoplasms;
Survivors
- MeSH:
Adolescent;
Age Factors;
Brain Neoplasms/mortality/pathology/radiotherapy;
Child;
Child, Preschool;
Disease Progression;
Female;
Follow-Up Studies;
Hematopoietic Stem Cell Transplantation;
Hematopoietic Stem Cells/cytology;
Humans;
Infant;
Infant, Newborn;
Lymphoma/mortality/pathology/radiotherapy;
Male;
Multivariate Analysis;
Neoplasms/mortality/*pathology/radiotherapy;
Risk Factors;
Severity of Illness Index;
Survival Rate
- From:Journal of Korean Medical Science
2013;28(5):755-762
- CountryRepublic of Korea
- Language:English
-
Abstract:
Recent advances in childhood cancer treatment have increased survival rates to 80%. Two out of three survivors experience late effects (LEs). From a group of 241 survivors previously described, 193 were followed at the long-term follow-up clinic (LTFC) of Severance Hospital in Korea; the presence of LEs was confirmed by oncologists. We reported the change in LEs during 3 yr of follow-up. The median follow-up from diagnosis was 10.4 yr (5.1-26.2 yr). Among 193 survivors, the percentage of patients with at least one LE increased from 63.2% at the initial visit to 75.1% at the most recent visit (P = 0.011). The proportion of patients having multiple LEs and grade 2 or higher LEs increased from the initial visit (P = 0.001 respectively). Forty-eight non-responders to the LTFC were older and had less frequent and severe LEs than responders at initial visit (all P < 0.05). In multivariate analysis, younger age at diagnosis, older age at initial visit, a diagnosis of a brain tumor or lymphoma, and use of radiotherapy were significant risk factors for LEs (all P < 0.05). Adverse changes in LEs were seen among the survivors, regardless of most clinical risk factors. They need to receive comprehensive, long-term follow up.
