The Aflac Cancer Center and Blood Disorders Service at Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia 30342, USA.
Pediatr Blood Cancer. 2010 Jul 1;54(7):976-82. doi: 10.1002/pbc.22431.
The Common Terminology Criteria for Adverse Events v3.0 (CTCAE) was designed for reporting acute and late effects of cancer treatment. To date, no study of pediatric-aged cancer survivors has graded health conditions using CTCAE, for patients in active follow-up in a cancer survivor program.
Medical records were reviewed on 519 survivors of non-central nervous system childhood malignancies seen in the Cancer Survivor Program between January 1, 2001 and December 15, 2005. Health problems identified through histories, physicals, and recommended evaluation using the Children's Oncology Group (COG) Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancer were graded using the CTCAE.
Overall, 1,625 adverse health conditions were reported or detected in 519 pediatric-age cancer survivors (mean age at diagnosis 4.8 years; mean age at first survivor visit 12.1 years). The majority of conditions were mild (47.4% Grade 1) or moderate (35.2% Grade 2); however, 17.4% of conditions were severe (Grade 3) or life-threatening/disabling (Grade 4). Only 12.1% of survivors had no adverse condition, and 36.2% of survivors had a Grade 3 or 4 condition. In a Cox multivariate analysis risk factors for a Grade 3 or 4 condition included minority race, diagnosis of other malignancy, older age, and a history of a hematopoietic stem cell transplant.
The majority of adverse health conditions in pediatric-aged cancer survivors are mild; however, a significant percentage will have a serious condition. Long-term follow-up with a multidisciplinary approach is essential to detect and intervene in health problems early.
通用不良事件术语标准 3.0（CTCAE）是为报告癌症治疗的急性和迟发性效应而设计的。迄今为止，尚无研究使用 CTCAE 对癌症幸存者计划中正在积极随访的儿科癌症幸存者的健康状况进行分级。
对 2001 年 1 月 1 日至 2005 年 12 月 15 日期间在癌症幸存者计划中就诊的 519 名非中枢神经系统儿童恶性肿瘤幸存者的病历进行了回顾。通过病史、体检以及根据儿童肿瘤学组（COG）对儿童、青少年和年轻成人癌症幸存者的长期随访指南建议进行的评估，确定健康问题，并使用 CTCAE 进行分级。
总体而言，在 519 名儿科癌症幸存者（诊断时平均年龄为 4.8 岁；首次就诊时的平均年龄为 12.1 岁）中报告或检测到 1625 种不良健康状况（12.1%的幸存者无不良状况，36.2%的幸存者有 3 级或 4 级状况。在 Cox 多变量分析中，3 级或 4 级状况的危险因素包括少数民族、诊断为其他恶性肿瘤、年龄较大和造血干细胞移植史。
儿科癌症幸存者的大多数不良健康状况是轻度的；然而，仍有相当一部分人会有严重的疾病。采用多学科方法进行长期随访对于早期发现和干预健康问题至关重要。
