Abstract
Background: Improved survival after childhood cancer is attributed to intensive, aggressive therapy,
adverse sequelae of which can manifest months to years after completion of treatment.
There is little information about the late adverse effects of both childhood cancer
and its therapy in survivors in India. Aim: To determine the long-term sequelae associated with therapy in childhood cancer survivors
attending a tertiary cancer center in India. Materials and Methods: We studied 155 consecutive survivors of childhood cancer who were ≤14 years at the
time of diagnosis and had completed 3 years of follow-up. The study included a complete
history and clinical examination, with specific investigations to detect organ toxicity.
Quality of life (QOL) was assessed from responses to a standardized questionnaire.
Neurocognitive assessment was carried out in 20 survivors with an adaptation of the
revised Wechsler adult intelligence scale for adults and the Malins intelligence scale
for children. Results: The late effects included impaired fertility in 38 patients (24.5%), impaired growth
pattern in 7 (4.5%), endocrine dysfunction in 7 (4.5%) and second malignancy in 2
(1.2%). Three of the 20 patients assessed had severe neurocognitive impairment. A
high QOL was reported by 60% of survivors and an "average" QOL by 38%. Conclusion: Our study showed that most survivors had a good QOL and our results will help clinicians
to better monitor childhood cancer survivors in countries with limited resources.
Key words
Childhood cancer - follow-up - late effects - survivors
