Guidelines for Complications of Cancer Treatment Vol VIII Part B

Gaslini Children’s Research Hospital of Genoa, Italy.PATIENTS AND METHODS: All cases with a diagnosis ofmalignancy in childhood and a minimum of 2.5 years fromdiscontinuation of treatment were considered eligible. For allcases the study included physical, endocrinological, andpsychological examination. Groups of patients selectedaccording to treatment underwent cardiac, pulmonary,orthopedic, and ophthalmologic evaluation. The sequelaeobserved were scored according to a grading system in whichasymptomatic subclinical defects are distinguished from thosethat are sufficiently symptomatic to require some type ofcorrective measure. RESULTS: Overall, 200 of 288 cases(69.4%) presented with some kind of abnormality.Symptomatic changes were present in 92 cases (42%); in these,severe and life-threatening late toxicity was reported in 61(21.2%) and 12 cases (4.2%), respectively. The major riskfactors appeared to be irradiation, type of tumor, and whetherthe patient had received therapy before 1974.CONCLUSIONS: In our experience, this study demonstratesthat there was a true excess of morbidity caused by the diseaseand its treatment in long-term survivors from almost any kindof childhood cancer. It also sheds light on how to prevent,diagnose, and adequately treat these patients and proposesspecific criteria for the evaluation of the severity of delayedtoxicity in long-term survivors of cancer in childhood.4) Risk-based health monitoring of childhood cancersurvivors: a report from the Children’s OncologyGroupNunez SB, Mulrooney DA, Hudson MM. Curr Oncol Rep.2007; 6 :440-52Because of therapeutic advances over the past 50 years, longtermsurvival is now a reality for nearly 80% of children andadolescents diagnosed with cancer. The growing population417