[Late side-effects of treatment in patients with nephroblastoma]

Abstract

The aim of the study was to analyse late side-effects of the antineoplastic treatment in patients with diagnosed nephroblastoma.

Material and methods: In the years 1986-2002, 80 children were treated in the Gdańsk Centre, for nephroblastoma, 13 of them followed SIOP-6, 25 were treated according to SIOP-9 and the remaining 42, SIOP 93-01 programme.

Results: 70 patients had long-term clinical remission. 10 patients died, 3 of them due to treatment complications (all were treated in accordance with SIOP 92-01: 1 - mycotic sepsis, 1 intra-operative hemorrhage and 1 - typhlitis), the other 7 due to disease progression (2 on the SIOP-6, 2 on the SIOP-9 and 3 on the SIOP 93-01 protocol). The late diagnosed complications of the treatment were: cardiomiopathy in 7 children, renal insufficiency in 1 case (the girl is presently after kidney transplant), tubulopathy in 4, proteinuria in 3, arterial 1 hypertension in 6, scoliosis in 9, chronic hepatitis (exclusively in children treated before 1994): type B in 11 (one girl has portal hypertension and esophageal varices), type C in 12 and both B and C in 5 children. Of the endocrinologic complications 4 patients were diagnosed with hipergonadotrophic hypogonadism. Secondary, neoplasms that were diagnosed several years from the completion of the nephroblastoma treatment, were the cause of death in 3 children (2 osteosarconma and 1 chondrosarconma).

Conclusions: The advance in the treatment of neoplasia that has been achieved due to modern diagnostic and therapeutic procedures and the continual increase in the number of survivals obliges us the provide the patients with extensive specialistic and continuous medical care.