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Long‐term medical effects of childhood and adolescent rhabdomyosarcoma: A report from the childhood cancer survivor study
Author(s) -
Punyko Judith A.,
Mertens Ann C.,
Gurney James G.,
Yasui Yutaka,
Donaldson Sarah S.,
Rodeberg David A.,
Raney R. Beverly,
Stovall Marilyn,
Sklar Charles A.,
Robison Leslie L.,
Baker K. Scott
Publication year - 2005
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20310
Subject(s) - medicine , pediatrics , medical record , rhabdomyosarcoma , incidence (geometry) , adverse effect , relative risk , cancer , pediatric cancer , cohort , surgery , sarcoma , confidence interval , physics , pathology , optics
Background This study was conducted to evaluate the incidence of adverse medical conditions and to assess the risk of developing these conditions in a cohort of long‐term survivors of rhabdomyosarcoma (RMS) diagnosed before age 21. Procedure Using data from the Childhood Cancer Survivor Study (CCSS), we evaluated the incidence of self‐reported adverse medical conditions for 606 RMS survivors and 3,701 siblings of cancer survivors. Cancer and treatment data abstracted from medical records were used to evaluate the effects of primary tumor site and combined modality therapy on the risk of developing sequelae in survivors. Results The relative risk (RR) for developing sequelae among survivors compared with siblings was greatest within 5 years after diagnosis. RR was elevated more than 5 years after diagnosis for several conditions (RR, 95% CI) as follows: eye impairment (cataract: 7.4, 2.9–18.9; visual disturbances: 3.2, 2.0–5.1; very dry eyes: 2.0, 1.2–3.3), endocrine impairment (growth hormone deficiency: 83.9, 33.0–213.6; hypothyroidism: 6.9, 4.1–11.3; need for medications to induce puberty: 90.4, 30.2–270.5), cardiopulmonary impairment (congestive heart failure: 43.0, 12.7–145.5; angina‐like symptoms: 2.0, 1.3–2.9), neurosensory impairment (legal blindness: 9.8, 4.8–20.0; abnormal sensations: 1.5, 1.0–2.2), and neuromotor impairment (repeated seizures: 2.3, 1.2–4.4; motor problems: 3.7, 2.2–6.4; problems chewing or swallowing: 3.8, 1.9–7.5). Conclusions Survivors are at risk for developing sequelae many years after their initial diagnosis and treatment. Continued medical surveillance is necessary to ensure the long‐term health and well‐being of RMS survivors. Pediatr Blood Cancer 2005;44:643–653. © 2005 Wiley‐Liss, Inc.