Long-term complications in survivors of advanced stage neuroblastoma.
BACKGROUND
Few studies have assessed late effects in neuroblastoma (NB) survivors, particularly those with advanced stage disease.


METHODS
Retrospective analysis of a cohort of advanced stage NB survivors followed in a late effect clinic at a single institution. Screening tests to detect late effects were tailored depending on the individual's treatment exposures.


RESULTS
The study included 63 survivors (31 males). The median age at diagnosis was 3.0 years. The median follow-up from diagnosis was 7.06 years. All patients had surgery and received chemotherapy, 89% received radiation therapy (RT), 62% immunotherapy, and 56% autologous stem cell transplant. Late complications were detected in 95% of survivors and included: hearing loss (62%), primary hypothyroidism (24%), ovarian failure (41% of females), musculoskeletal (19%), and pulmonary (19%) abnormalities. The majority of complications were moderate, with only 4% being life-threatening. Survivors who received cisplatin were at greater risk to develop hearing loss compared to those not so treated (OR 9.74; 95% CI: 0.9-101.6). A total dose of cyclophosphamide greater than 7.4 g was associated with ovarian failure (P = 0.02).


CONCLUSIONS
Late complications occur frequently in survivors of advanced stage NB. The majority of these problems are of mild-moderate severity. Long-term follow-up (LFTU) and screening of this population is essential.
Laverdière
Caroline
C
Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
Cheung
Nai-Kong V
NK
Kushner
Brian H
BH
Kramer
Kim
K
Modak
Shakeel
S
LaQuaglia
Michael P
MP
Wolden
Suzanne
S
Ness
Kirsten K
KK
Gurney
James G
JG
Sklar
Charles A
CA
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000009:adverse effects; D004700:Endocrine System Diseases / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000209:etiology; D009447:Neuroblastoma / Q000150:complications* / Q000628:therapy*; D009519:New York City / Q000453:epidemiology; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D017741:Survivors
D000970:Antineoplastic Agents