Primary Care Management of the Childhood Cancer Survivor

Kurt, Beth A.; Armstrong, Gregory T.; Cash, Darlene K.; Krasin, Matthew J.; Morris, E. Brannon; Spunt, Sheri L.; Robison, Leslie L.; Hudson, Melissa M.

doi:10.1016/j.jpeds.2007.10.002

Cited by 23 publications

(16 citation statements)

References 27 publications

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“…Treatment modalities of childhood ALL consisting of cranial irradiation, high dose intravenous methotrexate (MTX), and intrathecal MTX are associated with neurocognitive impairment [20]. CNS prophylaxis with cranial irradiation is a significant risk for deficits in intellectual and cognitive performances compared to without cranial irradiation [21].…”

Section: Discussionmentioning

confidence: 99%

Late effects in survivors of childhood acute lymphoblastic leukemia: a study from Thai Pediatric Oncology Group

et al. 2010

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Survivors of childhood acute lymphoblastic leukemia (ALL) are at risk of long-term late effects. Therefore, systematic screenings of the late complications are essential. The objective of this study was to determine the prevalence of late effects of Thai children and adolescents after completion of ALL therapy. We performed a cross-sectional study for evaluation of the late effects in ALL survivors who came for follow-up at 10 pediatric oncology centers in Thailand. We evaluated the treatment-related late complications of children and adolescents who had finished ALL treatment for at least 2 years. Demographic data, treatment modalities, and late effects were recorded and analyzed. There were 258 survivors with a median age of 12.2 years (range 3.6-23.3 years). The median follow-up time was 7.2 years (range 2-17.5 years). Forty-seven percent (122 cases) suffered from at least one late effect. Overweight/obesity was the most common late effect. Radiation of central nervous system was a significant risk factor for overweight/obesity (OR 1.97, 95% CI 1.02-3.81) and educational problems (OR 4.3, 95% CI 1.32-14.02). Our data have demonstrated a significant prevalence of late effects after childhood ALL therapy. A long-term follow-up program for survivors of childhood cancer is therefore needed in our country.

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Section: Discussionmentioning

confidence: 99%

Late effects in survivors of childhood acute lymphoblastic leukemia: a study from Thai Pediatric Oncology Group

et al. 2010

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“…(Hudson et al, 2003;Aziz et al, 2006;Goldsby et al, 2006;Maule et al, 2007;Kurt et al, 2008;Mertens et al, 2008;Oeffinger et al, 2008) There is also some evidence that childhood cancer and its treatment can have persisting negative effects on parents (Hardy et al, 2008) in relation to both finance and lifestyle (Cohn et al, 2003).…”

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confidence: 99%

Trends in incidence of childhood cancer in Australia, 1983–2006

et al. 2010

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BACKGROUND: There are few population-based childhood cancer registries in the world containing stage and treatment data. METHODS: Data from the population-based Australian Paediatric Cancer Registry were used to calculate incidence rates during the most recent 10-year period (1997 -2006) and trends in incidence between 1983 and 2006 for the 12 major diagnostic groups of the International Classification of Childhood Cancer. RESULTS: In the period 1997 -2006, there were 6184 childhood cancer (at 0 -14 years) cases in Australia (157 cases per million children). The commonest cancers were leukaemia (34%), that of the central nervous system (23%) and lymphomas (10%), with incidence the highest at 0 -4 years (223 cases per million). Trend analyses showed that incidence among boys for all cancers combined increased by 1.6% per year from 1983 to 1994 but have remained stable since. Incidence rates for girls consistently increased by 0.9% per year. Since 1983, there have been significant increases among boys and girls for leukaemia, and hepatic and germ-cell tumours, whereas for boys, incidence of neuroblastomas and malignant epithelial tumours has recently decreased. For all cancers and for both sexes combined, there was a consistent increase ( þ 0.7% per year, 1983 -2006) at age 0 -4 years, a slight nonsignificant increase at 5 -9 years, and at 10 -14 years, an initial increase (2. 7% per year, 1983 -1996) followed by a slight nonsignificant decrease. CONCLUSION: Although there is some evidence of a recent plateau in cancer incidence rates in Australia for boys and older children, interpretation is difficult without a better understanding of what underlies the changes reported.

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“…Although the Australian childhood cancer incidence rate represents less than 1% of all invasive cancers diagnosed in this country, it is still the most common cause of disease-related death for children between 1–14 years of age in Australia (Australian Institute of Health and Welfare, 2009). Many survivors face significant long-term adverse health effects because of the cancer itself or as a result of treatment (Aziz et al , 2006; Goldsby et al , 2006; Kurt et al , 2008; Landier and Bhatia, 2008; Oeffinger et al , 2008). The diagnosis of cancer in a child also has a considerable and ongoing impact, both psychological and financial, on the families concerned (Cohn et al , 2003; Hardy et al , 2008).…”

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confidence: 99%

Population-based survival estimates for childhood cancer in Australia during the period 1997–2006

et al. 2010

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Background:This study provides the latest available relative survival data for Australian childhood cancer patients.Methods:Data from the population-based Australian Paediatric Cancer Registry were used to describe relative survival outcomes using the period method for 11 903 children diagnosed with cancer between 1983 and 2006 and prevalent at any time between 1997 and 2006.Results:The overall relative survival was 90.4% after 1 year, 79.5% after 5 years and 74.7% after 20 years. Where information onstage at diagnosis was available (lymphomas, neuroblastoma, renal tumours and rhabdomyosarcomas), survival was significantly poorer for more-advanced stage. Survival was lower among infants compared with other children for those diagnosed with leukaemia, tumours of the central nervous system and renal tumours but higher for neuroblastoma. Recent improvements in overall childhood cancer survival over time are mainly because of improvements among leukaemia patients.Conclusion:The high and improving survival prognosis for children diagnosed with cancer in Australia is consistent with various international estimates. However, a 5-year survival estimate of 79% still means that many children who are diagnosed with cancer will die within 5 years, whereas others have long-term health morbidities and complications associated with their treatments. It is hoped that continued developments in treatment protocols will result in further improvements in survival.

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Primary Care Management of the Childhood Cancer Survivor

Cited by 23 publications

References 27 publications

Late effects in survivors of childhood acute lymphoblastic leukemia: a study from Thai Pediatric Oncology Group

Late effects in survivors of childhood acute lymphoblastic leukemia: a study from Thai Pediatric Oncology Group

Trends in incidence of childhood cancer in Australia, 1983–2006

Population-based survival estimates for childhood cancer in Australia during the period 1997–2006

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