Changes to This Summary (10/18/2013)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Revised text to state that research has clearly demonstrated that late effects contribute to a high burden of morbidity among adults treated for cancer during childhood, with 60% to over 90% developing one or more chronic health conditions and 20% to 80% experiencing severe or life-threatening complications during adulthood (cited Hudson et al. as reference 12).
Also added text to state that variability in prevalence is related to differences in age and follow-up time of the cohorts studied and the methods and consistency of assessment.
Added Boukheris et al. as reference 19.
Added text about a study that observed an approximate 2.5-fold increased risk of melanoma among members of their cohort (median time to development, 21.0 years); family history of cancer, demographic, or treatment-related factors did not predict risk of melanoma (cited Pappo et al. as referene 24).
Added text about a study that reported a significant excess of subsequent renal carcinoma among 14,358 5-year survivors in the cohort compared with the general population; highest risk was observed among neuroblastoma survivors and among those treated with renal-directed radiation therapy of 5 Gy or greater and platinum-based chemotherapy (cited as Wilson et al. as reference 50).
Added Brinkman et al. [Neuro Oncol] as reference 15.
Added text to state that longitudinal cohort studies have provided insight into predictors of cognitive decline among long-term survivors of CNS tumors.
Added text to state that neurocognitive deficits have also been linked to poor social outcomes including poor social adjustment, problems with peer relationship, and withdrawn/depressed behaviors among survivors of pediatric embryonal tumors (cited Brinkman et al. [J Clin Oncol] as reference 18).
Added text about a Dutch study in which hepatobiliary dysfunction was observed in 8.7% of 1,362 long-term survivors evaluated by alanine aminotransferase for hepatocellular injury and gamma-glutamyltransferase for biliary tract injury (cited Mulder et al. as reference 31).
Added text to state that single-center cohort study of 532 adult long-term survivors observed that treatment but not genetic variation was strongly associated with the occurrence of the components of the metabolic syndrome; metabolic syndrome was more frequent in cranially and abdominally irradiated survivors than in nonirradiated survivors (cited van Waas et al. as reference 64).
Added text to state that despite disease- and treatment-related risks for bone mineral density deficits, the prevalence of self-reported fractures among CCSS participants was lower than that reported by sibling controls. Predictors of increased prevalence of fracture by multivariable analyses included increasing age at follow-up, white race, methotrexate treatment, and balance difficulties among females and smoking history and white race among male survivors (cited as Wilson et al. as reference 50).
Added text about about a Dutch study that used inhibin B as surrogate marker of gonadal function in 201 male survivors of childhood cancer and suggested that recovery of gonadal function after cytotoxic chemotherapy and radiation therapy is possible but not if inhibin B is already at a critically low level (cited van Dorp et al. and Green et al. as references 32 and 33, respectively).
Added text about a large, Dutch, cross-sectional study of 1,442 childhood cancer survivors that assessed the presence of albuminuria, hypomagnesemia, hypophosphatemia, and hypertension and estimated glomerular filtration rate among survivors treated with ifosfamide, cisplatin, carboplatin, high-dose cyclophosphamide, or high-dose methotrexate; radiation of the kidney region or total-body irradiation; or nephrectomy (cited Knijnenburg et al. as reference 23).
This summary is written and maintained by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.