title: Comprehensive clinical follow-up of late effects in childhood cancer survivors shows the need for early and well-timed intervention.
abstract: BACKGROUND
  Due to recent advances in treatment, nearly 80% of childhood cancer patients become long-term survivors. Studies on the late effects of survivors are under way worldwide. However, data on Asian survivors remain limited.
  
  
  METHODS
  Data on 241 survivors at the Long-term Follow-up Clinic in Severance Hospital, South Korea, were collected and late effects were confirmed by oncologists.
  
  
  RESULTS
  The median follow-up from diagnosis was 7.8 years. Late effects were identified in 59.8% of survivors and 23.2% had two or more late effects. Grade 3 or higher late effects were present in 10.8%. The most common late effects involved endocrine system (29.0%). Late effects were present in 95.7% of brain tumor survivors and 36.0% of Wilms' tumor survivors. Chemotherapy, hematopoietic stem-cell transplantation and radiotherapy were significant factors associated with the number and severity of late effects (P < 0.05). Brain tumor survivors had more severe late effects (P < 0.001), whereas Wilms' tumor survivors had fewer and milder late effects (P < 0.05).
  
  
  CONCLUSIONS
  The observation that over 50% of cancer survivors suffered from late effects during the short follow-up period and that a high frequency of endocrine late effects was present indicates the need for early and well-timed intervention of the survivors.
authors.affiliation: Department of Pediatric Hematology and Oncology, Yonsei University Health System, Seoul, Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Han
authors.forename: S Y
authors.initials: SY
authors.lastname: Kwon
authors.forename: S C
authors.initials: SC
authors.lastname: Won
authors.forename: Y J
authors.initials: YJ
authors.lastname: Shin
authors.forename: J H
authors.initials: JH
authors.lastname: Ko
authors.forename: C J
authors.initials: CJ
authors.lastname: Lyu
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000970:Antineoplastic Agents / Q000009:adverse effects; D044466:Asian People; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care; D004703:Endocrine System / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007723:Korea; D008297:Male; D020380:Needs Assessment; D009369:Neoplasms / Q000208:ethnology / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology*; D011832:Radiation Injuries; D012306:Risk; D017741:Survivors / Q000523:psychology*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents