Childhood Cancer Research Group, Danish Cancer Society Research Center, Denmark; German Childhood Cancer Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Germany.
Childhood Cancer Research Group, Danish Cancer Society Research Center, Denmark.
Cancer Epidemiol. 2021 Apr;71(Pt B):101733. doi: 10.1016/j.canep.2020.101733. Epub 2020 May 24.
Since the 1960s, paediatric oncologists have gradually become better organised in large study groups and participation in clinical trials is today considered as the standard of care, with most children with cancer in Europe and North America being enrolled on available treatment protocols. Chemotherapy is nowadays the main element of therapy, but irradiation is still required for some patients. With the advent of multimodality therapy and supportive care, five-year cancer survival exceeds 80 % in most European and North American countries today. The substantial improvements in survival led to a constantly growing population of childhood cancer survivors. Concerns regarding the risk of late effects of the intensive cancer treatment at a young age, together with increasing numbers of survivors, have directed attention towards survivorship research. Survivors of childhood cancer are at longstanding risk of various severe somatic and mental health conditions attributable to the cancer and its treatment, as well as adverse social and socioeconomic consequences, and diminished psychological well-being and quality of life. It is, however, important to stress that some survivors have no or very mild adverse health conditions. Nevertheless, joint efforts are warranted for the care and long-term follow-up of childhood cancer patients. With this article, we provide a comprehensive overview of improvements in survival and treatment modalities over time, as well as the related somatic and mental late effects, and social and socioeconomic difficulties that these children might encounter later in life.
自 20 世纪 60 年代以来，儿科肿瘤学家逐渐在大型研究组中组织起来，参与临床试验如今被认为是护理标准，欧洲和北美的大多数癌症儿童都按照可用的治疗方案进行治疗。化疗是当今治疗的主要手段，但一些患者仍需要放疗。随着多模式治疗和支持性护理的出现，当今大多数欧洲和北美的国家癌症五年生存率超过 80%。生存的显著改善导致了儿童癌症幸存者人数的不断增加。由于担心年轻时密集癌症治疗的晚期影响，再加上幸存者人数的增加，人们对生存者研究给予了关注。儿童癌症幸存者长期存在各种严重的躯体和心理健康状况的风险，这些风险归因于癌症及其治疗，以及不良的社会和社会经济后果，以及心理健康和生活质量下降。然而，重要的是要强调，有些幸存者没有或只有非常轻微的健康状况。尽管如此，仍需要共同努力，为儿童癌症患者的护理和长期随访提供支持。通过本文，我们全面概述了随着时间的推移，在生存和治疗方式方面的改善，以及这些儿童在以后的生活中可能遇到的躯体和精神方面的晚期影响，以及社会和社会经济方面的困难。
