Catamnesis of pediatric thoracic and abdominal cancer survivours

Abstract

Background. Malignancies of thoracic and abdominal localization are the second in pediatric oncopathology, after hemoblastoses. A progress in treatment of this heterogeneous tumors had been achieved by surgery approaches, chemotherapy, supportive care and irradiation role definition in multimodal therapy. Inspite of high survival rate, health condition of pediatric thoracic and abdominal cancer survivours in 5 years and more time in our country are unknown. Aim. To analyze health condition of pediatric thoracic and abdominal cancer survivours and kids, who were born in survivours families. Materials and methods. 324 patients, survived from thoracic and abdominal malignancies were enrolled the study from 1979 to 2015. Patients were subdided into 2 groups: 1st - 126 (38.9%) patients, treated from 1979 to 1996 and 2nd - 198 (61.1%) patients - from 1997 to 2015. Such approach aligned with historical treatment modification - upward 1996 modern anticancer treatment protocols are using and indications for irradiation are limited. Results. By improving therapy of nephroblastoma, decreased number of skeletal disorders from 11.5% in 1st group to 3.9% in 2nd, but increased concomitant renal complications from 5.3% to 21.5% and endocrinopathy from 2.4% to 6.7% in 1st and 2nd groups respectively. In hepar tumours survivours, chronic gastroduodenitis and pancreatoduodenopathy were registrated in 25% and 16% in 1st and 2nd groups respectively. In neuroblastoma survivours, locomotor system pathology (including osteoporosis) was found in 12.1%. Second malignant tumours in period from 8 months to 25 years after end of treatment were in 0,9%, benign - 1,6% of pediatric thoracic and abdominal cancer survivours. Kids, who were born in survivours families, had health condition as their equals in age without oncological family anamnesis. Conclusions. Catamnesis of pediatric thoracic and abdominal cancer survivours can predict possible complications, develop individual rehabilitation and personalized follow up programs. Besides, afterhistory data can help in development of complex treatment approaches for this heterogenous tumours.

Keywords

• catamnesis
• neuroblastoma
• nephroblastoma
• hepatoblastoma
• treatment
• late side-effects
• second tumors
• reproduction
• children