Division of Clinical Research and Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington.
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
Semin Oncol. 2020 Feb;47(1):23-39. doi: 10.1053/j.seminoncol.2020.02.007. Epub 2020 Mar 4.
With the widespread adoption of multimodality treatment, 5-year survival of children diagnosed with cancer has improved dramatically in the past several decades from approximately 60% in 1970 to greater than 85% currently. As a result, there are an estimated nearly half a million long-term survivors of childhood cancer living in the United States today. However, survivors have, on average, significantly greater serious medical and psychosocial late effects compared with the general population. In this review, we will discuss the current epidemiology of childhood cancer survivorship, including new methods to estimate the burden of late effects and genetic susceptibility toward late effects. We will also review the development of surveillance guidelines for childhood cancer survivors and early toxicity signals from novel agents now being tested and used increasingly to treat pediatric and adult cancers. We conclude with an overview of current models of survivorship care and areas for future research.
随着多模式治疗的广泛采用，过去几十年中，被诊断患有癌症的儿童的 5 年生存率显著提高，从 1970 年的约 60%提高到目前的 85%以上。因此，今天在美国估计有近 50 万名儿童癌症的长期幸存者。然而，与一般人群相比，幸存者平均有更多严重的医疗和心理社会后期影响。在这篇综述中，我们将讨论儿童癌症生存者的当前流行病学，包括评估后期影响负担和对后期影响的遗传易感性的新方法。我们还将回顾儿童癌症幸存者监测指南的制定以及目前正在测试和越来越多地用于治疗儿科和成人癌症的新型药物的早期毒性信号。最后，我们概述了当前的生存护理模式和未来研究的领域。
