LONG TERM COMPLICATIONS IN CHILDREN TREATED FOR ADVANCED NEUROBLASTOMA
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Tipo de produção
conferenceObject
Data de publicação
2012
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY PERIODICALS, INC
Citação
PEDIATRIC BLOOD & CANCER, v.59, n.6, Special Issue, p.1060-1060, 2012
Resumo
Purpose: Advanced neuroblastoma (stage 3 and 4) requires aggressive treatment, including surgery, chemo and radiotherapy and autologous bone marrow transplantation. Although long term survival rates are disappointing, those children who survive are prone to develop long term complications. Our aim is to report the long term complications rate and quality in children treated for stage 3 and 4 neuroblastoma. Methods: The charts of stage 3 and 4 children with neuroblastoma treated from January/1983 through October/2003 were reviewed and those surviving and with no evidence of disease for more than 5 years were selected. Late effects were classified as second malignancies, endocrinological, neuromotor, hepatic, sensorial, benign tumors, infectious diseases and psychiatric disease and others. Associations with treatment modalities were disclosed. Results: Among 263 children with stage 3 and 4 neuroblastoma, 40 (15%) are long term survivors. 20/40 (50%) present one or more complications, being 2 (10%) second malignant neoplasia, 4 (20%) endocrinological disturbances, 4 (20%) neuromotor, 5 (25%) hepatic, 4 (20%) sensorial, 3 (1.1%) benign tumors, and infertility, psychiatric disease and hepatitis C infection in 1 (5%) episode each. 10/20 (50%) of the children were less than 18 months at diagnosis, and 12/20 (60%) were stage 3 and 8/20 (40%) were stage 4. All children were submitted to chemotherapy and 7/20 (35%) to autologous bone marrow transplantation. In 10/20 (50%) patients radiotherapy was also included, and 4/10 (40%) presented functional lesions in the irradiated field. All endocrinologic sequelae were detected in the ABMT group. Second malignant neoplasia were not related to RDT(1 ALL and 1 thyroid carcinoma). Conclusion: Children surviving aggressive therapy for neuroblastoma are at risk of late effects, particularly endocrinological and neurological complications, requiring close observation to prompt intervention when necessary, avoiding impairments in quality of life or even life threatening situations. Second malignant neoplasia require special concern.