Skip to main content

Advertisement

SpringerLink
Log in

Late effects and quality of life of childhood cancer survivors: Part 2. Impact of radiotherapy

  • Original Article
  • Published:
International Journal of Hematology Aims and scope Submit manuscript

Abstract

To examine the late effects and health-related quality of life of childhood cancer survivors (CCS) after radiotherapy (RT), we performed a cross-sectional survey using self-rating questionnaires. The subjects were divided into 3 groups: CCS treated with or without RT, and a general population matched for age, gender, residential area, and work status. The numbers in each group were 113, 72, and 1,000, respectively. The median ages of CCS at diagnosis and the time of the survey were 8 and 22 years, respectively. The mean final heights of males and females were significantly lower in CCS with RT than in the other 2 groups. Risk factors for a short stature were total body irradiation (TBI) [odds ratio (OR) 17.8, p < 0.001], spinal irradiation (OR 8.31, p = 0.033), and an age younger than 10 years at diagnosis. Late effects were observed in 68% of CCS with RT compared with 36% of CCS without RT. Multivariate analysis revealed that TBI was significantly associated with endocrine dysfunction (OR 12.3), skull and spinal irradiation with cognitive dysfunction (OR 16.1 and 11.5, respectively), and spinal irradiation with a short stature (OR 14.1), respectively. Physical dysfunction, psychological stress, and problems of social adaptation were observed in >50% of CCS with RT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Robison LL, Armstrong GT, Boice JD, Chow EJ, Davies SM, Donaldson SS, et al. The Childhood Cancer Survivor Study: a National Cancer Institute-supported resource for outcome and intervention research. J Clin Oncol. 2009;27(14):2308–18. doi:10.1200/JCO.2009.22.3339.

    Article  PubMed  Google Scholar 

  2. Hawkins MM, Lancashire ER, Winter DL, Frobisher C, Reulen RC, Taylor AJ, et al. The British Childhood Cancer Survivor Study: objectives, methods, population structure, response rates and initial descriptive information. Pediatr Blood Cancer. 2008;50(5):1018–25. doi:10.1002/pbc.21335.

    Article  CAS  PubMed  Google Scholar 

  3. Geenen MM, Cardous-Ubbink MC, Kremer LC, van den Bos C, van der Pal HJ, Heinen RC, et al. Medical assessment of adverse health outcomes in long-term survivors of childhood cancer. JAMA. 2007;297(24):2705–15.

    Google Scholar 

  4. Diller L, Chow EJ, Gurney JG, Hudson MM, Kadin-Lottick NS, Kawashima TI, et al. Chronic disease in the Childhood Cancer Survivor Study cohort: a review of published findings. J Clin Oncol. 2009;27(14):2339–55. doi:10.1200/JCO.2008.21.1953.

    Article  PubMed  Google Scholar 

  5. Ishida Y, Honda M, Ozono S, Okamura J, Asami K, Maeda N, et al. Late effects and quality of life of childhood cancer survivors: Part 1 Impact of the stem cell transplantation. Int J Hematol. 2010. doi:10.1007/s12185-010-0584-y.

  6. Green DM, Sklar CA, Boice JD Jr, Mulvihill JJ, Whitton JA, Stovall M, et al. Ovarian failure and reproductive outcomes after childhood cancer treatment: results from the Childhood Cancer Survivor Study. J Clin Oncol. 2009;27(14):2374–81. doi:10.1200/JCO.2008.21.1839.

    Article  PubMed  Google Scholar 

  7. Hudson MM, Mulrooney DA, Bowers DC, Sklar CA, Green DM, Donaldson SS, et al. High-risk populations identified in Childhood Cancer Survivor Study investigations: implications for risk-based surveillance. J Clin Oncol. 2009;27(14):2405–14. doi:10.1200/JCO.2008.21.1516.

    Article  PubMed  Google Scholar 

  8. Meadows AT, Friedman DL, Neglia JP, Mertens AC, Donaldson SS, Stovall M, et al. Second neoplasms in survivors of childhood cancer: findings from the Childhood Cancer Survivor Study cohort. J Clin Oncol. 2009;27(14):2356–62. doi:10.1200/JCO.2008.21.1920.

    Article  PubMed  Google Scholar 

  9. Maeda M. Late effects of childhood cancer: life-threatening issues. J Nippon Med Sch. 2008;75(6):320–4. doi:JST.JSTAGE/jnms/75.320[pii].

    Article  PubMed  Google Scholar 

  10. Miyoshi Y, Ohta H, Hashii Y, Tokimasa S, Namba N, Mushiake S, et al. Endocrinological analysis of 122 Japanese childhood cancer survivors in a single hospital. Endocr J. 2008;55(6):1055–63. doi:JST.JSTAGE/endocrj/K08E-075[pii].

    Article  PubMed  Google Scholar 

  11. Ishiguro H, Yasuda Y, Tomita Y, Shinagawa T, Shimizu T, Morimoto T, et al. Long-term follow-up of thyroid function in patients who received bone marrow transplantation during childhood and adolescence. J Clin Endocrinol Metab. 2004;89(12):5981–6.

    Google Scholar 

  12. Ishida Y, Honda M, Kamibeppu K, Ozono S, Iwai T, Kakee N, et al. Cross-sectional survey on the late effects and QOL of childhood cancer survivors, Part 1. J Jpn Pediatr Soc. 2010;114(4):665–75.

    Google Scholar 

  13. Gurney JG, Ness KK, Stovall M, Wolden S, Punyko JA, Neglia JP, et al. Final height and body mass index among adult survivors of childhood brain cancer: childhood cancer survivor study. J Clin Endocrinol Metab. 2003;88(10):4731–9.

    Google Scholar 

  14. Chow EJ, Friedman DL, Yasui Y, Whitton JA, Stovall M, Robison LL, et al. Decreased adult height in survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. J Pediatr. 2007;150(4):370–5, 375.e1. doi:10.1016/j.jpeds.2006.11.036.

    Google Scholar 

  15. Noorda EM, Somers R, van Leeuwen FE, Vulsma T, Behrendt H. Adult height and age at menarche in childhood cancer survivors. Eur J Cancer. 2001;37(5):605–12. doi:S095980490000438X[pii].

    Article  CAS  PubMed  Google Scholar 

  16. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med. 2006;355(15):1572–82. doi:10.1056/NEJMsa060185.

    Article  CAS  PubMed  Google Scholar 

  17. Nandagopal R, Laverdiere C, Mulrooney D, Hudson MM, Meacham L. Endocrine late effects of childhood cancer therapy: a report from the Children’s Oncology Group. Horm Res. 2008;69(2):65–74. doi:10.1159/000111809.

    Article  CAS  PubMed  Google Scholar 

  18. Chemaitilly W, Boulad F, Sklar C. Endocrine complications of childhood hematopoietic stem-cell transplantation. In: Kline R, editor. Pediatric hematopoietic stem cell transplantation. New York: Informa Healthcare USA; 2006. p. 287–398.

  19. Rutter MM, Rose SR. Long-term endocrine sequelae of childhood cancer. Curr Opin Pediatr. 2007;19(4):480–7. doi:10.1097/MOP.0b013e3282058b56-00008480-200708000-00017[pii].

    Article  PubMed  Google Scholar 

  20. Sanders JE. Endocrine complications of high-dose therapy with stem cell transplantation. Pediatr Transplant. 2004;8(Suppl 5):39–50.

    Google Scholar 

  21. Askins MA, Moore BD 3rd. Preventing neurocognitive late effects in childhood cancer survivors. J Child Neurol. 2008;23(10):1160–71. doi:10.1177/0883073808321065.

    Article  PubMed  Google Scholar 

  22. Brownstein CM, Mertens AC, Mitby PA, Stovall M, Qin J, Heller G, et al. Factors that affect final height and change in height standard deviation scores in survivors of childhood cancer treated with growth hormone: a report from the childhood cancer survivor study. J Clin Endocrinol Metab. 2004;89(9):4422–7.

    Google Scholar 

  23. Larson DL, Kroll S, Jaffe N, Serure A, Goepfert H. Long-term effects of radiotherapy in childhood and adolescence. Am J Surg. 1990;160(4):348–51.

    Google Scholar 

  24. Kony SJ, de Vathaire F, Chompret A, Shamsaldim A, Grimaud E, Raquin MA, et al. Radiation and genetic factors in the risk of second malignant neoplasms after a first cancer in childhood. Lancet. 1997;350(9071):91–5. doi:10.1016/S0140-6736(97)01116-1.

    Article  CAS  PubMed  Google Scholar 

  25. Neglia JP, Friedman DL, Yasui Y, Mertens AC, Hammond S, Stovall M, et al. Second malignant neoplasms in five-year survivors of childhood cancer: childhood cancer survivor study. J Natl Cancer Inst. 2001;93(8):618–29.

    Google Scholar 

  26. Han JW, Kwon SY, Won SC, Shin YJ, Ko JH, Lyu CJ. Comprehensive clinical follow-up of late effects in childhood cancer survivors shows the need for early and well-timed intervention. Ann Oncol. 2009;20(7):1170–7. doi:10.1093/annonc/mdn778.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The institutions that provided patient data and recruited CCS to the survey are listed in Table 1. This study was supported by research grants from the Japanese Ministry of Health, Labour and Welfare (Grant No. 18-14: “Study of quality of life and prognosis in childhood cancer survivors and establishment of a long-term follow-up system”).

Conflict of interest statement

The authors declare no financial interests.

Author information

Authors and Affiliations

  1. Department of Pediatrics, St. Luke’s International Hospital, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan

    Yasushi Ishida

  2. Department of Epidemiology, National Research Institute for Child Health and Development, Tokyo, Japan

    Naoko Sakamoto

  3. Department of Family Nursing, The University of Tokyo, Tokyo, Japan

    Kiyoko Kamibeppu

  4. Department of Health Policy, National Research Institute for Child Health and Development, Tokyo, Japan

    Naoko Kakee

  5. Department of Hemato-oncology, Kagawa Children’s Hospital, Kagawa, Japan

    Tsuyako Iwai

  6. Department of Pediatrics, Kurume University School of Medicine, Fukuoka, Japan

    Shuichi Ozono & Hiroko Inada

  7. Department of Pediatrics and Clinical Research Center, Nagoya Medical Center, Aichi, Japan

    Naoko Maeda & Keizo Horibe

  8. Institute for Clinical Research, National Kyusyu Cancer Center, Fukuoka, Japan

    Jun Okamura

  9. Department of Pediatrics, Niigata Cancer Center Hospital, Niigata, Japan

    Keiko Asami

  10. Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan

    Yasushi Ishida & Misato Honda

Authors
  1. Yasushi Ishida
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Naoko Sakamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kiyoko Kamibeppu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Naoko Kakee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tsuyako Iwai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shuichi Ozono
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Naoko Maeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jun Okamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Keiko Asami
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hiroko Inada
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Misato Honda
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Keizo Horibe
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yasushi Ishida.

About this article

Cite this article

Ishida, Y., Sakamoto, N., Kamibeppu, K. et al. Late effects and quality of life of childhood cancer survivors: Part 2. Impact of radiotherapy. Int J Hematol 92, 95–104 (2010). https://doi.org/10.1007/s12185-010-0611-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12185-010-0611-z

Keywords

Search

Navigation