SPECIAL ARTICLE |
Department of Pediatrics, University of Vermont College of Medicine, Burlington, Vermont
In this article the difficulties that face survivors of childhood cancer therapy are presented, and the late effects of such therapy, separated into nonmalignant and malignant late effects, are discussed according to organ system. Recommendations for monitoring the late effects are set forth. A table listing radiation-therapy site and chemotherapeutic agents and selected late effects that result from their use is provided. Finally, a brief recommendation regarding the establishment of a late-effects clinic is also presented.
Key Words: late effects childhood cancer cancer therapy cancer survivors
Abbreviations: CCSS—Childhood Cancer Survivor Study RR—relative risk CNS—central nervous system BC—breast cancer COG—Children's Oncology Group H&P—history and physical examination SMN—second malignant neoplasm SIR—standardized incidence ratio TC—thyroid cancer AER—absolute excess risk AML—acute myelogenous leukemia MDS—myelodysplastic syndrome t-AML/MDS, treatment-related acute myelogenous leukemia/myelodysplastic syndrome
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