Childhood cancer: Survival, treatment modalities, late effects and improvements over time. (April 2021)

• Record Type: Journal Article
• Authors: Erdmann, Friederike; Frederiksen, Line Elmerdahl; Bonaventure, Audrey; Mader, Luzius; Hasle, Henrik; Robison, Leslie L.; Winther, Jeanette Falck
• Is Part Of: Cancer epidemiology. Volume 71(2021)Part B
• Publication Date: 2021-04
• Subjects: Childhood cancer -- Survival -- Cancer treatment -- Temporal changes -- Survivorship -- Somatic late effects -- Mental late effects -- Social and socioeconomic conditions -- Survivor cohorts; Cancer -- Epidemiology -- Periodicals; Cancer -- Prevention -- Periodicals; Cancer -- Diagnosis -- Periodicals; Carcinogenesis -- Periodicals; 616.994005
• DOI: 10.1016/j.canep.2020.101733
• Languages: English
• ISSNs: 1877-7821

Abstract

Highlights: Improvements in childhood cancer survival led to increasing numbers of survivors. Childhood cancer is treated within multiinstitutional clinical trials. Chemotherapy is the main element of therapy but irradiation is still needed in some. Survivors are at longstanding risk of severe somatic late effects. Survivors may face various social and socioeconomic difficulties in adulthood. Abstract: Since the 1960s, paediatric oncologists have gradually become better organised in large study groups and participation in clinical trials is today considered as the standard of care, with most children with cancer in Europe and North America being enrolled on available treatment protocols. Chemotherapy is nowadays the main element of therapy, but irradiation is still required for some patients. With the advent of multimodality therapy and supportive care, five-year cancer survival exceeds 80 % in most European and North American countries today. The substantial improvements in survival led to a constantly growing population of childhood cancer survivors. Concerns regarding the risk of late effects of the intensive cancer treatment at a young age, together with increasing numbers of survivors, have directed attention towards survivorship research. Survivors of childhood cancer are at longstanding risk of various severe somatic and mental health conditions attributable to the cancer and its treatment, as well as adverse social and socioeconomic consequences, and diminished psychological well-being and quality of life. It is, however, important to stress that some survivors have no or very mild adverse health conditions. Nevertheless, joint efforts are warranted for the care and long-term follow-up of childhood cancer patients. With this article, we provide a comprehensive overview of improvements in survival and treatment modalities over time, as well as the related somatic and mental late effects, and social and socioeconomic difficulties that these children might encounter later in life.