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Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India
Despite an increasing number of survivors of childhood cancer (CCS) in low- and middle-income countries, survivorship care is in its nascent stages. We describe the spectrum of late effects seen, challenges faced, and lessons learnt over three decades of a late effects program in India. METHODS: We...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9668554/ https://www.ncbi.nlm.nih.gov/pubmed/36332172 http://dx.doi.org/10.1200/GO.22.00044 |
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author | Prasad, Maya Goswami, Savita Chinnaswamy, Girish Banavali, Shripad D. Kurkure, Purna A. |
author_facet | Prasad, Maya Goswami, Savita Chinnaswamy, Girish Banavali, Shripad D. Kurkure, Purna A. |
author_sort | Prasad, Maya |
collection | PubMed |
description | Despite an increasing number of survivors of childhood cancer (CCS) in low- and middle-income countries, survivorship care is in its nascent stages. We describe the spectrum of late effects seen, challenges faced, and lessons learnt over three decades of a late effects program in India. METHODS: We describe the demographics and profile of late effects of all CCS survivors enrolled in our After Completion of Treatment Clinic from February 5, 1991 (inception) to February 4, 2021. We analyzed the trends by the decade of diagnosis. RESULTS: There were 3,067 CCS survivors, the median age was 18 years (range, 3-57 years), and the median follow-up was 11 years (range, 2-46 years). Two thirds (62.4%) had either no or mild late effects, 480 (15.6%), 497 (16.2%), and 162 (5.3%) had grades 2, 3, and 4 late effects, with 67 deaths reported. Notable late effects were chronic viral hepatitis (7.8%), thyroid dysfunction (7.5%), other endocrine issues (13.6%), psychosocial issues (57%), neurocognitive impairment (4.1%), and metabolic syndrome (4%). The cumulative incidence and severity of late effects showed a consistent decline by the decade of diagnosis. Twenty-two percent of survivors are lost to follow-up. CONCLUSION: Survivors of childhood cancer treated on contemporary treatment protocols have a significantly lower side-effect profile. Attrition to long-term follow-up and psychosocial issues are significant concerns. Understanding the unique spectrum of late effects and establishing a holistic support system go a long way in ensuring the long-term physical and mental health and psychosocial concerns of childhood cancer survivors in low- and middle-income countries. |
format | Online Article Text |
id | pubmed-9668554 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-96685542022-11-17 Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India Prasad, Maya Goswami, Savita Chinnaswamy, Girish Banavali, Shripad D. Kurkure, Purna A. JCO Glob Oncol ORIGINAL REPORTS Despite an increasing number of survivors of childhood cancer (CCS) in low- and middle-income countries, survivorship care is in its nascent stages. We describe the spectrum of late effects seen, challenges faced, and lessons learnt over three decades of a late effects program in India. METHODS: We describe the demographics and profile of late effects of all CCS survivors enrolled in our After Completion of Treatment Clinic from February 5, 1991 (inception) to February 4, 2021. We analyzed the trends by the decade of diagnosis. RESULTS: There were 3,067 CCS survivors, the median age was 18 years (range, 3-57 years), and the median follow-up was 11 years (range, 2-46 years). Two thirds (62.4%) had either no or mild late effects, 480 (15.6%), 497 (16.2%), and 162 (5.3%) had grades 2, 3, and 4 late effects, with 67 deaths reported. Notable late effects were chronic viral hepatitis (7.8%), thyroid dysfunction (7.5%), other endocrine issues (13.6%), psychosocial issues (57%), neurocognitive impairment (4.1%), and metabolic syndrome (4%). The cumulative incidence and severity of late effects showed a consistent decline by the decade of diagnosis. Twenty-two percent of survivors are lost to follow-up. CONCLUSION: Survivors of childhood cancer treated on contemporary treatment protocols have a significantly lower side-effect profile. Attrition to long-term follow-up and psychosocial issues are significant concerns. Understanding the unique spectrum of late effects and establishing a holistic support system go a long way in ensuring the long-term physical and mental health and psychosocial concerns of childhood cancer survivors in low- and middle-income countries. Wolters Kluwer Health 2022-11-04 /pmc/articles/PMC9668554/ /pubmed/36332172 http://dx.doi.org/10.1200/GO.22.00044 Text en © 2022 by American Society of Clinical Oncology https://creativecommons.org/licenses/by-nc-nd/4.0/Creative Commons Attribution Non-Commercial No Derivatives 4.0 License: http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | ORIGINAL REPORTS Prasad, Maya Goswami, Savita Chinnaswamy, Girish Banavali, Shripad D. Kurkure, Purna A. Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India |
title | Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India |
title_full | Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India |
title_fullStr | Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India |
title_full_unstemmed | Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India |
title_short | Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India |
title_sort | long-term outcomes in survivors of childhood cancer: a 30-year experience from india |
topic | ORIGINAL REPORTS |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9668554/ https://www.ncbi.nlm.nih.gov/pubmed/36332172 http://dx.doi.org/10.1200/GO.22.00044 |
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