Increasing and worsening late effects in childhood cancer survivors during follow-up

• Published in: Journal of Korean medical science Vol. 28; no. 5; pp. 755 - 762
• Main Authors: Han, Jung Woo, Kim, Hyo Sun, Kim, Beom Sik, Kwon, Seung Yeon, Shin, Yoon Jung, Kim, Sun Hee, Ko, Jong Hee, Lyu, Chuhl Joo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.05.2013; 대한의학회
• Subjects: Adolescent; Age Factors; Brain Neoplasms - mortality; Brain Neoplasms - pathology; Brain Neoplasms - radiotherapy; Child; Child, Preschool; Disease Progression; Female; Follow-Up Studies; Hematopoietic Stem Cell Transplantation; Hematopoietic Stem Cells - cytology; Humans; Infant; Infant, Newborn; Lymphoma - mortality; Lymphoma - pathology; Lymphoma - radiotherapy; Male; Multivariate Analysis; Neoplasms - mortality; Neoplasms - pathology; Neoplasms - radiotherapy; Original; Risk Factors; Severity of Illness Index; Survival Rate; 의학일반; Late Effects; Complications; Health; Morbidity; Neoplasms; Survivors
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2013.28.5.755

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.