HE INTRODUCTION OF MORE EFfective treatments for childhood cancer has dramatically improved survival rates, implying that childhood cancer survivors comprise a rapidly growing group of young adults. 1,2 Unfortunately, improved prognosis has been accompanied by the occurrence of late, treatment-related complications such as second neoplasms, organ dysfunction, and psychosocial and cognitive problems. 3,4 Late treatment sequelae will increase the incidence of chronic diseases in survivors and ultimately re-For editorial comment see p 2762.

CCSs have a high risk of developing symptomatic CEs at an early age. The most common CE was CHF. Survivors treated with both anthracyclines and radiotherapy have the highest risk; after 30 years, one in eight will develop severe heart disease. The use of potentially cardiotoxic treatments should be reconsidered for high-risk groups, and frequent follow-up for high-risk survivors is needed.

Concomitant platin-based radio-chemotherapy may improve survival of patients with locally advanced NSCLC. However, the available data are insufficient to accurately define the size of such a potential treatment benefit and the optimal schedule of chemotherapy.

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A high percentage (27%) of young adult CCSs have an abnormal cardiac function. The strongest predictors of subclinical cardiac dysfunction are anthracycline dose, cardiac irradiation, and younger age at diagnosis. There is a suggestion that daunorubicin is less cardiotoxic than other anthracyclines.