Published online March 1, 2007
PEDIATRICS Vol. 119 No. 3 March 2007, pp. 554-568 (doi:10.1542/peds.2006-2826)
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SPECIAL ARTICLE

The Late Effects of Childhood Cancer Therapy

Joseph D. Dickerman, MD

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

Accepted Nov 21, 2006.




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