Division of Pediatric Hematology/Oncology, Blood and Marrow Transplantation, Lombardi Comprehensive Cancer Center, Georgetown University Hospital,Washington, DC 20007-2197, USA.
Curr Oncol Rep. 2012 Apr;14(2):182-90. doi: 10.1007/s11912-012-0224-1.
Advances continue to be made in the field of pediatric oncology ever since treatment for childhood cancer began in 1948. Since then, there has been exponential progress in the care for children with cancer as reflected in the current survival rates, which approach 90%. With such incredible survival rates, the number of childhood cancer survivors has increased significantly, with present estimates being above 300,000 in the United States alone. This success has, however, not been without cost. Long-term studies of cancer survivors have brought to light specific adverse effects of therapy, which often present years after treatment is finished, termed “late effects.” Over the years, it has become apparent that monitoring for and treating these late effects of treatment is essential for the continuing health of young cancer survivors. It is now well recognized that childhood cancer survivors require long-term follow-up care given by an integrated team of qualified and invested specialty-care providers in collaboration with their primary caregivers. These teams deliver care using a risk-based approach, following a systematic plan for lifelong screening,surveillance, and prevention that incorporates risks based on the previous cancer, cancer therapy, genetic predispositions,lifestyle behaviors, and co-morbid health conditions.
自 1948 年开始治疗儿童癌症以来，儿科肿瘤学领域不断取得进展。自那时以来，癌症患儿的治疗取得了指数级的进步，目前的生存率接近 90%。如此令人难以置信的生存率使得儿童癌症幸存者的数量显著增加，仅在美国，目前的估计就超过 30 万。然而，这一成功并非没有代价。对癌症幸存者的长期研究揭示了治疗的特定不良反应，这些不良反应通常在治疗结束多年后出现，称为“晚期效应”。多年来，人们已经清楚地认识到，监测和治疗这些治疗的晚期效应对于年轻癌症幸存者的持续健康至关重要。现在人们已经认识到，儿童癌症幸存者需要由合格和有投资意愿的专业护理提供者的综合团队，以及他们的初级护理提供者，提供长期的后续护理。这些团队使用基于风险的方法提供护理，遵循系统的终生筛查、监测和预防计划，该计划基于先前的癌症、癌症治疗、遗传易感性、生活方式行为和合并健康状况来确定风险。
