Department of Pediatrics, St. Luke's International Hospital, 10-1 Akashi-cho, Chuo-ku, Tokyo, Japan.
Int J Hematol. 2010 Jul;92(1):95-104. doi: 10.1007/s12185-010-0611-z. Epub 2010 Jun 25.
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.
为了研究儿童癌症幸存者（CCS）在接受放疗（RT）后的晚期效应和健康相关生活质量，我们使用自我评估问卷进行了一项横断面调查。受试者分为 3 组：接受或未接受 RT 治疗的 CCS 组，以及年龄、性别、居住地区和工作状态相匹配的一般人群组。每组的人数分别为 113、72 和 1000。CCS 在诊断时和调查时的中位年龄分别为 8 岁和 22 岁。男性和女性的平均最终身高在接受 RT 治疗的 CCS 中明显低于其他 2 组。矮小的危险因素是全身照射（TBI）[比值比（OR）17.8，p < 0.001]、脊柱照射（OR 8.31，p = 0.033）和诊断时年龄小于 10 岁。接受 RT 治疗的 CCS 中有 68%出现了晚期效应，而未接受 RT 治疗的 CCS 中只有 36%出现了晚期效应。多变量分析显示，TBI 与内分泌功能障碍显著相关（OR 12.3），颅骨和脊柱照射与认知功能障碍显著相关（OR 分别为 16.1 和 11.5），脊柱照射与身材矮小显著相关（OR 14.1）。接受 RT 治疗的 CCS 中超过 50%出现了身体功能障碍、心理压力和社会适应问题。
