von der Weid N, Beck D
Unité d'onco-hématologie, CHUV, Lausanne.
Schweiz Med Wochenschr. 1993 Jun 26;123(25):1293-9.
An ever-growing number of children with malignant diseases can today be cured and will have prolonged survival. Their quality of life, which can be altered by a substantial number of late effects of the disease or its treatment, is a prominent field of long-term assessment. In a cross-sectional study based on clinical and paraclinical parameters and covering 59 children and young adults treated between 1981 and 1986 for a childhood malignant disease, we investigated late effects in the long-term survivors. Late effects were found in 36 (61%) of these patients; their spectrum is wide, but most often affected are the CNS and the musculoskeletal system. Two thirds of the patients have mild or moderate and one third severe problems. The frequency of the late effects and the type of problem vary greatly according to the initial diagnosis; our results show a significant difference of severity according to the number of affected systems (p < 0.05). The results of our study match those of other similar reports and confirm the high frequency of late effects in survivors of pediatric cancer. A prospective study, assessing a large population of patients, is needed to determine the underlying causes and to develop primary and secondary prevention strategies.
如今，越来越多患有恶性疾病的儿童能够被治愈，并将延长生存期。他们的生活质量可能会因疾病或其治疗的大量晚期效应而改变，这是长期评估的一个突出领域。在一项基于临床和辅助临床参数的横断面研究中，涵盖了1981年至1986年间接受儿童恶性疾病治疗的59名儿童和青年，我们调查了长期幸存者的晚期效应。在这些患者中，有36名（61%）出现了晚期效应；其范围广泛，但最常受影响的是中枢神经系统和肌肉骨骼系统。三分之二的患者有轻度或中度问题，三分之一有严重问题。晚期效应的频率和问题类型根据初始诊断有很大差异；我们的结果显示，根据受影响系统的数量，严重程度有显著差异（p<0.05）。我们的研究结果与其他类似报告的结果相符，并证实了儿童癌症幸存者中晚期效应的高发生率。需要进行一项前瞻性研究，评估大量患者，以确定潜在原因并制定一级和二级预防策略。
