Late-onset kidney failure in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study

Review – Late toxicity of abdominal and pelvic radiotherapy for childhood cancer

“…Anthracycline and ifosfamide dose (g/m 2 ) were also associated with increased risk, while age at diagnosis did not have a significant effect. [47] Based on the presented data, there is no clear indication to deviate from the current QUANTEC recommendations in radiotherapy for children, nor to make a distinction between different age groups. Spleen Asplenia, whether anatomic due to splenectomy or functional, e.g., due to RT, is associated with an increased risk of severe infection by encapsulated bacteria such as streptococcus pneumoniae.…”

“…Seven additional MEDLINE articles published after the scope of the Cochrane review (i.e., March 2017) were found. [42][43][44][45][46][47][48] Four articles described category B dose-effect relations (Table 1). [43,[46][47][48] The first study found significantly lower eGFR after abdominal RT for Wilms' tumour.…”

“…[42][43][44][45][46][47][48] Four articles described category B dose-effect relations (Table 1). [43,[46][47][48] The first study found significantly lower eGFR after abdominal RT for Wilms' tumour. In addition, cystatin-based eGFR showed a significant moderate correlation with prescribed irradiation dose, with a trend towards lower eGFR after prescribed doses ≥25 Gy.…”

Bilateral Renal Tumors in Children: The First 5 Years’ Experience of National Centralization in The Netherlands and a Narrative Review of the Literature

“…Unfortunately, from the larger series, only Hamilton et al (12%) and Montgomery et al (5%) presented data on ESKD [ 25 , 26 ]. Long-term follow-up studies in unilateral Wilms tumor have shown that kidney function may still decline decades after treatment for kidney tumors [ 10 , 11 , 12 , 13 , 71 ]. Therefore, follow-up time in some reports as well as our cohort may be too short to draw strong conclusions about renal outcome.…”

“…Whereas survival rates of patients with unilateral Wilms tumor are high, survival of patients with bilateral Wilms tumors seems highly variable, ranging from 43–91% [ 3 , 7 , 8 ]. Long-term outcomes are expected to be even less favorable, based on tumor behavior, but also due to disease- and treatment-related kidney disease with its subsequent comorbidity and corresponding lower life expectancy [ 9 , 10 , 11 , 12 , 13 ]. In addition, patients with bilateral renal tumors more frequently carry underlying genetic predisposition than patients with unilateral tumors [ 5 ].…”