title: Late effects of treatment in survivors of childhood cancer from a tertiary cancer center in South India.
abstract: BACKGROUND
  Improved survival after childhood cancer is attributed to intensive, aggressive therapy, adverse sequelae of which can manifest months to years after completion of treatment. There is little information about the late adverse effects of both childhood cancer and its therapy in survivors in India.
  
  
  OBJECTIVE
  To determine the long-term sequelae associated with therapy in childhood cancer survivors attending a tertiary cancer center in India.
  
  
  METHODS
  We studied 155 consecutive survivors of childhood cancer who were ≤14 years at the time of diagnosis and had completed 3 years of follow-up. The study included a complete history and clinical examination, with specific investigations to detect organ toxicity. Quality of life (QOL) was assessed from responses to a standardized questionnaire. Neurocognitive assessment was carried out in 20 survivors with an adaptation of the revised Wechsler adult intelligence scale for adults and the Malins intelligence scale for children.
  
  
  RESULTS
  The late effects included impaired fertility in 38 patients (24.5%), impaired growth pattern in 7 (4.5%), endocrine dysfunction in 7 (4.5%) and second malignancy in 2 (1.2%). Three of the 20 patients assessed had severe neurocognitive impairment. A high QOL was reported by 60% of survivors and an "average" QOL by 38%.
  
  
  CONCLUSIONS
  Our study showed that most survivors had a good QOL and our results will help clinicians to better monitor childhood cancer survivors in countries with limited resources.
authors.affiliation: Department of Medical Oncology, Cancer Institute Adyar, Chennai, Tamil Nadu, India.
authors.forename: Rejiv
authors.initials: R
authors.lastname: Rajendranath
authors.affiliation: Department of Psycho Oncology, Cancer Institute Adyar, Chennai, Tamil Nadu, India.
authors.forename: Surendran
authors.initials: S
authors.lastname: Veeraiah
authors.affiliation: Department of Medicine, Sri Ram Chandra Medical College, Chennai, Tamil Nadu, India.
authors.forename: Anita
authors.initials: A
authors.lastname: Ramesh
authors.affiliation: Department of Medical Oncology, Cancer Institute Adyar, Chennai, Tamil Nadu, India.
authors.forename: Tenali Gnana
authors.initials: TG
authors.lastname: Sagar
keywords: Childhood cancer; follow-up; late effects; survivors