Late Effects of Treatment for Childhood Cancer–for health professionals (PDQ®)

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Changes to This Summary (12/08/2015)

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.

General Information About Late Effects of Treatment for Childhood Cancer

Added text to state that an analysis of the Childhood Cancer Survivor Study (CCSS) and Surveillance, Epidemiology, and End Results (SEER) study evaluating conditional survival demonstrated a subsequent 5-year survival rate of 92% or higher among most diagnoses at 5 years, 10 years, 15 years, and 20 years. Among those who had survived at least 5 years from diagnosis, the probability of all-cause mortality in the next 10 years was 8.8% in the CCSS and 10.6% in the SEER study, with neoplasms accounting for cause of death in approximately 75% of survivors (cited Mertens et al. as reference 22).

Subsequent Neoplasms

Added text about the excess risk of subsequent neoplasms after the age of 40 years (cited Turcotte et al. as reference 3).

Added Chowdhry et al. as reference 20, Fidler et al. as reference 22, and Archer et al. as reference 70.

Late Effects of the Cardiovascular System

Added text about a collaborative study of North American and European pediatric cancer cohorts that evaluated the hazard ratio for clinical heart failure through age 40 years for doses of daunorubicin and doxorubicin (cited Feijen et al. as reference 28).

Added text to state that while these data suggest that dexrazoxane does protect the heart, there are not yet long-term data showing the impact of dexrazoxane on cardiac health (cited van Dalen et al. as reference 29).

Added text about the possible association between dexrazoxane and increased risk of second cancers (cited Chow et al. as reference 36).

Late Effects of the Central Nervous System

Added Khan et al. as reference 7.

Added text to state that radiation dose to specific subvolumes of the brain, including the temporal lobes and hippocampi, have been shown to significantly impact longitudinal intelligence quotients and academic achievement scores among children treated with craniospinal irradiation for medulloblastoma (cited Merchant et al. as reference 17).

Added Annett et al. as reference 49 and Iyer et al. as reference 54.

Added text about a cross-sectional study that evaluated neurologic morbidity and quality of life in 162 survivors of childhood acute lymphoblastic leukemia (ALL).

Added text about a CCSS study that evaluated psychological and neurocognitive function in 2,589 long-term cancer survivors who were diagnosed during adolescence and young adulthood (cited Prasad et al. as reference 86).

Late Effects of the Digestive System

Added text about a study from the CCSS that evaluated the incidence and risk of late-occurring intestinal obstruction requiring surgery in 12,316 5-year survivors and 4,023 siblings (cited Madenci et al. as reference 36 and level of evidence 3iiiC).

Late Effects of the Endocrine System

Added Li et al. as reference 14.

Late Effects of the Immune System

Added text to state that clinicians should consider and encourage the administration of inactivated vaccines and vaccines made of purified antigens, bacterial components, or genetically engineered recombinant antigens in all cancer and transplant survivors according to recommended doses and schedules (cited National Center for Immunization and Respiratory Diseases, Bridges et al., and Rubin et al. as references 6, 7, and 8, respectively).

Late Effects of the Musculoskeletal System

The Osteochondroma subsection was extensively revised.

Late Effects of the Respiratory System

Added text about a longitudinal study that evaluated the magnitude and trajectory of pulmonary dysfunction among 121 childhood cancer survivors treated with potentially pulmonary-toxic therapy (cited Armenian et al. as reference 4).

Late Effects of the Special Senses

Added text about the prevalence of cataracts, evaluated by serial slit lamp testing, among 271 participants in the Leucémie Enfants Adolescents (LEA) program (cited Horwitz et al. as reference 41).

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.

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