Hawkins M M, Stevens M C
Childhood Cancer Research Group, University of Oxford, Oxford, UK.
Br Med Bull. 1996 Oct;52(4):898-923. doi: 10.1093/oxfordjournals.bmb.a011590.
Recent research indicates that approximately 60% of children diagnosed with cancer in Britain are cured and as a result, about 1 in a 1000 of the general population will soon be survivors of childhood cancer. Unfortunately some elements of the therapies which are responsible for this remarkable success are associated with serious complications, sometimes decades after their administration. Therefore, a comprehensive knowledge of the risks and benefits of different therapies will only be obtained by monitoring the health of survivors indefinitely. With such therapeutic success, increasingly the composition of future treatment protocols will be influenced by knowledge of the risks of long term morbidity and mortality associated with past therapies. An awareness of the long term risks of complications of treatment is also important for estimating the future demand on the health services of this increasing proportion of the general population who together represent many life years of care. This chapter reviews what is known concerning the long term risks of complications of different treatments. Appropriate strategies for future clinical and epidemiological follow-up of the survivor population are discussed and the need for indefinite follow-up of the survivor population is emphasised.
最近的研究表明，在英国，约60%被诊断患有癌症的儿童得以治愈，因此，每1000名普通人群中约有1人将很快成为儿童癌症幸存者。不幸的是，促成这一显著成功的部分治疗方法会引发严重并发症，有时在治疗后数十年才出现。因此，只有通过对幸存者的健康状况进行无限期监测，才能全面了解不同治疗方法的风险和益处。鉴于治疗取得的成功，未来治疗方案的构成将越来越受到与过去治疗相关的长期发病和死亡风险知识的影响。了解治疗并发症的长期风险对于估计这一不断增加的普通人群对医疗服务的未来需求也很重要，这些幸存者总共需要多年的护理。本章回顾了不同治疗方法并发症的已知长期风险。讨论了对幸存者群体进行未来临床和流行病学随访的适当策略，并强调了对幸存者群体进行无限期随访的必要性。
