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Late Effects of Treatment for Childhood Cancer (PDQ®): Treatment - Health Professional Information [NCI] - Changes to This Summary (04 / 05 / 2013)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Subsequent Neoplasms

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Treatment of Undifferentiated Embryonal Sarcoma of the Liver

Treatment Options Undifferentiated embryonal sarcoma of the liver is so rare that only small series have been published regarding treatment. However, use of aggressive chemotherapy regimens seems to have improved the overall survival (OS). The generally accepted approach is to resect the primary tumor mass in the liver when possible. Neoadjuvant chemotherapy can be effective in decreasing an unresectable primary tumor mass, resulting in resectability.[1,2,3,4] The OS of these children appears...

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Revised text to state that thyroid cancer is observed after neck radiation for Hodgkin lymphoma, acute lymphoblastic leukemia, and brain tumors; after iodine I 131 metaiodobenzylguanidine (131 I-mIBG) treatment for neuroblastoma; and after total-body irradiation for hematopoietic stem cell transplantation (cited van Santen et al. as reference 30).

Revised text to state that any exposure to radiation was associated with increased risk, which demonstrated a linear dose-response relationship.

Late Effects of the Cardiovascular System

Added Blanco et al. as reference 22 and van der Pal et al. as reference 25.

Late Effects of the Central Nervous System (CNS)

Added Di Pinto et al. as reference 7.

Added text about the results of the St. Jude Total XV study regarding the risk of cognitive deficits following CNS-directed therapy with chemotherapy alone and the need for longitudinal follow-up (cited Conklin et al. as reference 20).

Late Effects of the Digestive System

Added Lee et al. as reference 56.

Late Effects of the Endocrine System

Added Thyroid nodules as a new subsection.

Revised Table 7 to include mIBG as a predisposing therapy for thyroid nodules.

Added Paris et al. as reference 65.

Late Effects of the Musculoskeletal System

Revised text to state that symptomatic osteonecrosis characterized by pain, joint swelling, and reduced mobility typically presents during the first 2 years of therapy, particularly in the case of acute lymphoblastic leukemia. Also added text to state that in some series, up to 40% of patients required some type of surgical procedure (cited Mattano et al. as reference 54).

Late Effects of the Special Senses

Added text about a study that evaluated audiological outcomes among 60 retinoblastoma survivors treated with nonmyeloablative systemic carboplatin and vincristine and reported on the cumulative incidence of hearing loss in those patients; younger age at the start of treatment was the only significant predictor of hearing loss (cited Qaddoumi et al. as reference 8).

This summary is written and maintained by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.

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WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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