Maeda Naoko, Saito Akiko, Kada Akiko, Imamura Toshihiko, Hayakawa Akira, Horibe Keizo, Sato Atsushi
Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan.
Department of Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan.
Pediatr Int. 2018 May;60(5):414-417. doi: 10.1111/ped.13528. Epub 2018 Mar 30.
Long-term follow up in adulthood after childhood cancer therapy is particularly important because of the risk of late effects, and information on the rate of continuing hospital visits by childhood cancer survivors (CCS) is also important for the planning of studies on the risk of late effects.
The rate of continuing hospital visits ("long-term follow up") in 1,252 cases registered in the multicenter Japan Association of Childhood Leukemia Study on Acute Lymphoblastic Leukemia (JACLS ALL-02) was investigated using data from its electronic data capture (EDC) system, including case number, date of diagnosis, date of therapy completion, date of birth, sex, survival or death, date of death, date of last outcome confirmation, and facility code. EDC entries of confirmed survival or death during the 2 years preceding the data lock represented continuing visitors, and the number of those cases, divided by the total number of cases (excluding cases of confirmation of death prior to those 2 years), was calculated as the proportion of continuing visitors (PCV).
The PCV for survivors of childhood acute lymphoblastic leukemia was found to decline over time from diagnosis. For subjects aged 21-29 years who were ≥9 years from diagnosis, PCV was approximately 30% overall, representing 23.5% for men and 41.8% for women, thus indicating a gender difference.
Further studies may be necessary to assess whether CCS who stopped visiting childhood cancer treatment facilities, actually received therapeutic intervention or appropriate screening for late effects as adults.
由于存在迟发效应风险，儿童癌症治疗后的成年期长期随访尤为重要，而儿童癌症幸存者（CCS）持续就诊率的信息对于迟发效应风险研究的规划也很重要。
利用多中心日本儿童白血病急性淋巴细胞白血病研究（JACLS ALL - 02）电子数据采集（EDC）系统的数据，调查了1252例登记病例的持续就诊率（“长期随访”），数据包括病例编号、诊断日期、治疗完成日期、出生日期、性别、生存或死亡情况、死亡日期、最后结局确认日期以及机构代码。数据锁定前2年内确认生存或死亡的EDC记录代表持续就诊者，这些病例数除以病例总数（不包括在这2年之前确认死亡的病例），计算得出持续就诊者比例（PCV）。
发现儿童急性淋巴细胞白血病幸存者的PCV从诊断后随时间下降。对于诊断后≥9年的21 - 29岁受试者，总体PCV约为30%，男性为23.5%，女性为41.8%，表明存在性别差异。
可能需要进一步研究来评估停止到儿童癌症治疗机构就诊的CCS作为成年人是否实际接受了治疗干预或针对迟发效应的适当筛查。
