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KMID : 0191120130280050755
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Journal of Korean Medical Science
2013 Volume.28 No. 5 p.755 ~ p.762
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Increasing and Worsening Late Effects in Childhood Cancer Survivors during Follow-up
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Han Jung-Woo
Kim Hyo-Sun
Kim Beom-Sik
Kwon Seung-Yeon
Shin Yoon-Jung
Kim Sun-Hee
Ko Jong-Hee
Lyu Chuhl-Joo
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Abstract
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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.
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KEYWORD
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Complications, Health, Late Effects, Morbidity, Neoplasms, Survivors
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