Long-term complications in survivors of advanced stage neuroblastoma Journal Article


Authors: Laverdiere, C.; Cheung, N. K. V.; Kushner, B. H.; Kramer, K.; Modak, S.; LaQuaglia, M. P.; Wolden, S.; Ness, K. K.; Gurney, J. G.; Sklar, C. A.
Article Title: Long-term complications in survivors of advanced stage neuroblastoma
Abstract: Background. Few studies have assessed late effects in neuroblastoma (NB) survivors, particularly those with advanced stage disease. Methods. Retrospective analysis of a cohort of advanced stage NB survivors followed in a late effect clinic at a single institution. Screening tests to detect late effects were tailored depending on the individual's treatment exposures. Results. The study included 63 survivors (31 males). The median age at diagnosis was 3.0 years. The median follow-up from diagnosis was 7.06 years. All patients had surgery and received chemotherapy, 89% received radiation therapy (RT), 62% immunotherapy, and 56% autologous stem cell transplant. Late complications were detected in 95% of survivors and included: hearing loss (62%), primary hypothyroidism (24%), ovarian failure (41 % of females), musculoskeletal (19%), and pulmonary (19%) abnormalities. The majority of complications were moderate, with only 4% being life-threatening. Survivors who received cisplatin were at greater risk to develop hearing loss compared to those not so treated (OR 9.74; 95% CI: 0.9-101.6). A total dose of cyclophosphamide greater than 7.4 g was associated with ovarian failure (P = 0.02). Conclusions. Late complications occur frequently in survivors of advanced stage NB. The majority of these problems are of mild-moderate severity. Long-term follow-up (LFTU) and screening of this population is essential. © 2005 Wiley-Liss, Inc.
Keywords: adolescent; adult; cancer survival; child; child, preschool; cancer surgery; survival rate; retrospective studies; unclassified drug; major clinical study; cisplatin; doxorubicin; advanced cancer; cancer combination chemotherapy; antineoplastic agents; cancer radiotherapy; radiation dose; combined modality therapy; cancer staging; drug megadose; follow up; follow-up studies; carboplatin; cancer immunotherapy; metastasis; etoposide; lung disease; logistic models; radiotherapy; cohort analysis; cyclophosphamide; autologous stem cell transplantation; clinical protocol; patient monitoring; retrospective study; risk factor; growth hormone; ifosfamide; growth hormone deficiency; ovary insufficiency; survivors; monoclonal antibody; disease severity; infant; infant, newborn; neuroblastoma; ganglioside gd2; cardiovascular disease; new york city; multivariate analysis; neoplasms, second primary; second cancer; hypothyroidism; screening test; radioimmunotherapy; logistic regression analysis; retinoic acid; thyroid hormone; musculoskeletal disease; hearing loss; monoclonal antibody 3f8 i 131; thyrotropin; follitropin; endocrine system diseases; luteinizing hormone; corticotropin; potassium iodide; ganglioside antibody; late effects from cancer treatment; monoclonal antibody gd2 3f8
Journal Title: Pediatric Blood and Cancer
Volume: 45
Issue: 3
ISSN: 1545-5009
Publisher: Wiley Periodicals, Inc  
Date Published: 2005-09-01
Start Page: 324
End Page: 332
Language: English
DOI: 10.1002/pbc.20331
PUBMED: 15714447
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 46" - "Export Date: 24 October 2012" - "CODEN: PBCEA" - "Source: Scopus"
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MSK Authors
  1. Brian Kushner
    311 Kushner
  2. Nai-Kong Cheung
    648 Cheung
  3. Charles A Sklar
    322 Sklar
  4. Kim Kramer
    236 Kramer
  5. Shakeel Modak
    249 Modak
  6. Suzanne L Wolden
    560 Wolden