Yuza Yuki
Dept. Hematology/Oncology, Tokyo Metropolitan Children's Medical Center.
Gan To Kagaku Ryoho. 2014 Jan;41(1):15-9.
Because of recent advances in cancer treatments, about 70% of childhood cancer patients can be cured and reach adulthood. Childhood cancer survivors(CCS)are estimated to account for one out of 1,000 adults currently in their 20s. In the continuing care of CCS, two aspects of long-term follow-up(LTFU)are necessary different from that of adulthood cancer survivors. As CCS receive cancer treatment, including chemotherapy and radiotherapy, during their growth phase, one aspect of LTFU is monitoring for late side effects on their physiological and psychosocial growth. The other aspect is transition medicine to encourage adolescent and young adult(AYA)-CCS into adult-oriented medicine to receive age-appropriate clinical care. Because there are differences between child-oriented medicine and adult-oriented medicine, AYA-CCS often refuse to visit adult-oriented clinics or avoid follow-ups. Therefore, the establishment of a comprehensive LTFU system is necessary, and transition medicine began being introduced in the 1990s. In Japan, the importance of these aspects has just begun to be recognized and the system is still not fully established. In this paper, we discuss these LTFU topics together with current situations in Japan.
由于癌症治疗的最新进展，约70%的儿童癌症患者能够治愈并长大成人。据估计，儿童癌症幸存者（CCS）在目前20多岁的成年人中占千分之一。在对CCS的持续护理中，长期随访（LTFU）的两个方面与成年癌症幸存者的情况有所不同。由于CCS在生长阶段接受包括化疗和放疗在内的癌症治疗，LTFU的一个方面是监测其对生理和心理社会成长的晚期副作用。另一个方面是过渡医学，鼓励青少年及青年（AYA）-CCS转向以成人为导向的医疗体系，以获得适合其年龄的临床护理。由于儿童导向型医学和成人导向型医学存在差异，AYA-CCS常常拒绝前往成人导向型诊所或逃避随访。因此，建立一个全面的LTFU系统很有必要，过渡医学在20世纪90年代开始被引入。在日本，这些方面的重要性刚刚开始得到认可，相关体系仍未完全建立。在本文中，我们将结合日本的现状来讨论这些LTFU主题。
