Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India
PURPOSEDespite an increasing number of survivors of childhood cancer (CCS) in low- and middle-income countries, survivorship care is in its nascent stages. We describe the spectrum of late effects seen, challenges faced, and lessons learnt over three decades of a late effects program in India.METHOD...
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| Format: | Article |
| Language: | English |
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American Society of Clinical Oncology
2022-11-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO.22.00044 |
| _version_ | 1798043769558269952 |
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| author | Maya Prasad Savita Goswami Girish Chinnaswamy Shripad D. Banavali Purna A. Kurkure |
| author_facet | Maya Prasad Savita Goswami Girish Chinnaswamy Shripad D. Banavali Purna A. Kurkure |
| author_sort | Maya Prasad |
| collection | DOAJ |
| description | PURPOSEDespite an increasing number of survivors of childhood cancer (CCS) in low- and middle-income countries, survivorship care is in its nascent stages. We describe the spectrum of late effects seen, challenges faced, and lessons learnt over three decades of a late effects program in India.METHODSWe describe the demographics and profile of late effects of all CCS survivors enrolled in our After Completion of Treatment Clinic from February 5, 1991 (inception) to February 4, 2021. We analyzed the trends by the decade of diagnosis.RESULTSThere were 3,067 CCS survivors, the median age was 18 years (range, 3-57 years), and the median follow-up was 11 years (range, 2-46 years). Two thirds (62.4%) had either no or mild late effects, 480 (15.6%), 497 (16.2%), and 162 (5.3%) had grades 2, 3, and 4 late effects, with 67 deaths reported. Notable late effects were chronic viral hepatitis (7.8%), thyroid dysfunction (7.5%), other endocrine issues (13.6%), psychosocial issues (57%), neurocognitive impairment (4.1%), and metabolic syndrome (4%). The cumulative incidence and severity of late effects showed a consistent decline by the decade of diagnosis. Twenty-two percent of survivors are lost to follow-up.CONCLUSIONSurvivors of childhood cancer treated on contemporary treatment protocols have a significantly lower side-effect profile. Attrition to long-term follow-up and psychosocial issues are significant concerns. Understanding the unique spectrum of late effects and establishing a holistic support system go a long way in ensuring the long-term physical and mental health and psychosocial concerns of childhood cancer survivors in low- and middle-income countries. |
| first_indexed | 2024-04-11T22:53:42Z |
| format | Article |
| id | doaj.art-8465ae53d9af4d649135dffc49f25af5 |
| institution | Directory Open Access Journal |
| issn | 2687-8941 |
| language | English |
| last_indexed | 2024-04-11T22:53:42Z |
| publishDate | 2022-11-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj.art-8465ae53d9af4d649135dffc49f25af52022-12-22T03:58:30ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412022-11-01810.1200/GO.22.00044Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From IndiaMaya Prasad0Savita Goswami1Girish Chinnaswamy2Shripad D. Banavali3Purna A. Kurkure4Division of Paediatric Oncology, Tata Memorial Centre, Parel, IndiaHomi Bhabha National Institute (HBNI), Anushakti Nagar, IndiaHomi Bhabha National Institute (HBNI), Anushakti Nagar, IndiaHomi Bhabha National Institute (HBNI), Anushakti Nagar, IndiaHomi Bhabha National Institute (HBNI), Anushakti Nagar, IndiaPURPOSEDespite an increasing number of survivors of childhood cancer (CCS) in low- and middle-income countries, survivorship care is in its nascent stages. We describe the spectrum of late effects seen, challenges faced, and lessons learnt over three decades of a late effects program in India.METHODSWe describe the demographics and profile of late effects of all CCS survivors enrolled in our After Completion of Treatment Clinic from February 5, 1991 (inception) to February 4, 2021. We analyzed the trends by the decade of diagnosis.RESULTSThere were 3,067 CCS survivors, the median age was 18 years (range, 3-57 years), and the median follow-up was 11 years (range, 2-46 years). Two thirds (62.4%) had either no or mild late effects, 480 (15.6%), 497 (16.2%), and 162 (5.3%) had grades 2, 3, and 4 late effects, with 67 deaths reported. Notable late effects were chronic viral hepatitis (7.8%), thyroid dysfunction (7.5%), other endocrine issues (13.6%), psychosocial issues (57%), neurocognitive impairment (4.1%), and metabolic syndrome (4%). The cumulative incidence and severity of late effects showed a consistent decline by the decade of diagnosis. Twenty-two percent of survivors are lost to follow-up.CONCLUSIONSurvivors of childhood cancer treated on contemporary treatment protocols have a significantly lower side-effect profile. Attrition to long-term follow-up and psychosocial issues are significant concerns. Understanding the unique spectrum of late effects and establishing a holistic support system go a long way in ensuring the long-term physical and mental health and psychosocial concerns of childhood cancer survivors in low- and middle-income countries.https://ascopubs.org/doi/10.1200/GO.22.00044 |
| spellingShingle | Maya Prasad Savita Goswami Girish Chinnaswamy Shripad D. Banavali Purna A. Kurkure Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India JCO Global Oncology |
| title | Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India |
| title_full | Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India |
| title_fullStr | Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India |
| title_full_unstemmed | Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India |
| title_short | Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India |
| title_sort | long term outcomes in survivors of childhood cancer a 30 year experience from india |
| url | https://ascopubs.org/doi/10.1200/GO.22.00044 |
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