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Review
. 2020 Dec;67(6):1237-1251.
doi: 10.1016/j.pcl.2020.07.013.

The Future of Childhood Cancer Survivorship: Challenges and Opportunities for Continued Progress

Stephanie B Dixon  1 , Eric J Chow  2 , Lars Hjorth  3 , Melissa M Hudson  4 , Leontien C M Kremer  5 , Lindsay M Morton  6 , Paul C Nathan  7 , Kirsten K Ness  8 , Kevin C Oeffinger  9 , Gregory T Armstrong  8
Affiliations
Review

The Future of Childhood Cancer Survivorship: Challenges and Opportunities for Continued Progress

Stephanie B Dixon et al. Pediatr Clin North Am. 2020 Dec.

Abstract

As treatment evolves and the population who survive childhood cancer ages and increases in number, researchers must use novel approaches to prevent, identify and mitigate adverse effects of treatment. Future priorities include collaborative efforts to pool large cohort data to improve detection of late effects, identify late effects of novel therapies, and determine the contribution of genetic factors along with physiologic and accelerated aging among survivors. This knowledge should translate to individual risk prediction and prevention strategies. Finally, we must utilize health services research and implementation science to improve adoption of survivorship care recommendations outside of specialized pediatric oncology centers.

Keywords: Adolescent; Cancer; Child; Delivery of health care; Neoplasms; Survivor; Treatment outcome.

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Conflict of interest statement

Disclosure The authors have nothing to disclose.

Figures

Figure 1.
Figure 1.
Percentage of survivors in the St. Jude Lifetime Cohort Study (SJLIFE) who meet the criteria for frailty compared with participants in the Cardiovascular Health Study and normal controls. N = 1,922 (50.3% male); mean time since diagnosis, 25.5 ± 7.7 years; mean age at diagnosis, 8.2 ± 5.6 years; 43% leukemia; 33% with cranial radiation exposure. From Ness KK, Kirkland JL, Gramatges MM, et al. Premature Physiologic Aging as a Paradigm for Understanding Increased Risk of Adverse Health Across the Lifespan of Survivors of Childhood Cancer. JClin Oncol. 2018;36(21):2206-2215; with permission.
Figure 2.
Figure 2.
Extrapolated figure hypothesizing that molecular integrity and associated physiologic capacity provoked by exposure to chemotherapy and/or radiation may be associated with excess risk and advanced onset of age-related diseases and frailty. From Ness KK, Kirkland JL, Gramatges MM, et al. Premature Physiologic Aging as a Paradigm for Understanding Increased Risk of Adverse Health Across the Lifespan of Survivors of Childhood Cancer. J Clin Oncol. 2018;36(21):2206-2215; with permission.
See this image and copyright information in PMC

References

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