Marina N
Department of Pediatrics, Stanford University School of Medicine, California, USA.
Pediatr Clin North Am. 1997 Aug;44(4):1021-42. doi: 10.1016/s0031-3955(05)70543-5.
The late effects of cancer therapy are a significant problem and the risk can be predicted based on each individual's prior therapy. Although the use of effective therapy has led to the development of sequelae involving various organ systems, recognition of these complications has led to the design of new therapy targeted at minimizing these effects, especially in patients with good risk. Unfortunately, the risks of the late effects must be accepted in patients with cancers that are aggressive or in advanced stages to maximize the chance for cure. Continued education of cancer survivors regarding their risks of late effects is essential and gives them the ability to maintain healthy lifestyles, avoiding cancer-promoting behaviors such as smoking. It also gives survivors the opportunity to participate in screening programs to help in early recognition of the late consequences of therapy and to learn self-examination to detect second malignancies early. It is hoped that the use of early intervention will lead to an improved long-term outcome. Finally, continued surveillance of this population is essential to monitor the impact of the therapeutic modifications on late complications and potentially to detect the sequelae produced by newer treatment strategies. Because the number of childhood cancer survivors will continue to increase, it is imperative that the pediatricians and internists in the community who care for these survivors are aware of their risks for late effects so that they have access to and can benefit from early intervention.
癌症治疗的晚期效应是一个重大问题，其风险可根据个体先前的治疗情况进行预测。尽管有效治疗的应用导致了涉及多个器官系统后遗症的出现，但对这些并发症的认识促使人们设计新的治疗方法，旨在将这些影响降至最低，尤其是对于风险较低患者而言。不幸地是，对于侵袭性或晚期癌症患者，为了最大程度提高治愈几率，必须接受晚期效应的风险。持续对癌症幸存者进行关于其晚期效应风险方面的教育至关重要，这使他们有能力保持健康的生活方式，避免诸如吸烟等促癌行为。这也让幸存者有机会参与筛查项目，以帮助早期识别治疗的晚期后果，并学习自我检查以便早期发现第二原发恶性肿瘤。人们希望早期干预措施的应用将带来更好的长期结果。最后，对这一群体持续进行监测对于评估治疗调整对晚期并发症的影响以及潜在地检测新治疗策略产生后遗症至关重要。由于儿童癌症幸存者的数量将持续增加，社区中负责照料这些幸存者的儿科医生和内科医生必须了解他们发生晚期效应的风险至关重要，这样他们才能获得早期干预并从中受益。
