Sehgal Mehak, Jain Vishesh, Agarwala Sandeep, Dhua Anjan, Goel Prabudh, Yadav Devendra Kumar, Bakhshi Sameer, Kalaivani Mani
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India.
J Indian Assoc Pediatr Surg. 2023 Nov-Dec;28(6):472-478. doi: 10.4103/jiaps.jiaps_104_23. Epub 2023 Nov 2.
In addition to the well-known toxicities of treatment, survivors of pediatric solid tumors can also develop other health-related conditions. They may either be an indirect consequence of therapy or could be unrelated to their prior history of malignancy. We aim to evaluate the nontoxicity related health conditions in survivors of pediatric solid tumors.
The study included a cohort of hepatoblastoma (HB), Wilm's tumor (WT), and malignant germ cell tumors (MGCT) survivors registered at pediatric surgical-oncology clinic from 1994 to 2016. Follow-up was done according to standard protocols and children were evaluated at each visit for any health-related conditions.
Of the survivors, 318 survivors, comprising of 48, 81, and 189 survivors of HB, MGCT, and WT, respectively, were included in the analysis. We found 20.8% of patients with HB, 11.1% of patients with MGCT, and 16.4% of patients with WT to report nontoxicity-related health issues. A high prevalence of surgical conditions (3.4%), secondary malignancies (1.2%), gynecological conditions in girls (16.9%), tuberculosis (1.2%), gallstone disease (0.9%), pelvi-ureteral junction obstruction (0.9%), and neurological issues (0.9%) was noted. Two presumed survivors had died, one due to a late recurrence and the other due to a secondary malignancy.
A high prevalence of medically or surgically manageable conditions makes it imperative to keep these children under follow-up to address any health-related conditions they may subsequently develop.
除了众所周知的治疗毒性外,小儿实体瘤幸存者还可能出现其他与健康相关的状况。它们可能是治疗的间接后果,也可能与他们先前的恶性肿瘤病史无关。我们旨在评估小儿实体瘤幸存者中与非毒性相关的健康状况。
该研究纳入了1994年至2016年在小儿外科肿瘤诊所登记的一组肝母细胞瘤(HB)、肾母细胞瘤(WT)和恶性生殖细胞肿瘤(MGCT)幸存者。按照标准方案进行随访,每次就诊时对儿童进行任何与健康相关状况的评估。
在幸存者中,分析纳入了318名幸存者,分别包括48名、81名和189名HB、MGCT和WT幸存者。我们发现,20.8%的HB患者、11.1%的MGCT患者和16.4%的WT患者报告了与非毒性相关的健康问题。注意到手术相关疾病(3.4%)、继发性恶性肿瘤(1.2%)、女孩的妇科疾病(16.9%)、结核病(1.2%)、胆结石疾病(0.9%)、肾盂输尿管连接处梗阻(0.9%)和神经问题(0.9%)的高患病率。两名推定的幸存者死亡,一名死于晚期复发,另一名死于继发性恶性肿瘤。
医学或手术可处理状况的高患病率使得必须对这些儿童进行随访,以解决他们随后可能出现的任何与健康相关的状况。