Among childhood cancer survivors, long-term survival continues to improve as treatment has been modified to reduce life-threatening, long-term side effects. These results were recently published in the New England Journal of Medicine.

Among children diagnosed with cancer in the 70s and 80s, nearly 20% of those who survived for 5 years following diagnosis died within the subsequent 25 years. The majority of these deaths were attributable to life-threatening late side effects caused by the same treatment that resulted in their cure, or the treatment that at least extended their survival for the couple of decades following their diagnosis.

As researchers and healthcare providers identified treatment that directly contributed to life-threatening, late side effects, therapeutic strategies were modified for childhood cancers in the 1990s to maintain cure rates, but reduce late side effects.

Researchers recently evaluated data to determine if changes in treatment strategies used to reduce late, life-threatening side effects among childhood cancer patients resulted in changes in long-term survival. The study included 34,033 patients in the Childhood Cancer Survivor Study cohort who survived at least 5 years after childhood cancer. The patients had been diagnosed with cancer before the age of 21 years, and they were treated during the period of 1970 through 1999. Median follow-up was 21 years.

  • At 15 years follow-up, death rates of patients from any cause were reduced during the 1970s through the 1990s.
  • During this time, death rates specific to health-related causes were also significantly reduced.
  • Reductions in certain treatment exposures were associated with a reduction death rates from life-threatening late side effects among survivors of acute lymphoblastic leukemia and Wilms’ tumor.

The researchers concluded that “The strategy of lowering therapeutic exposure has contributed to an observed decline in late mortality among 5-year survivors of childhood cancer.”

As therapeutic strategies continue to evolve to become more individualized therapies, long-term survival rates among survivors of childhood cancers have the potential to improve at an even greater rate.

Reference: Armstrong G, Chen Y, Yasui Y, et al. Reduction in Late Mortality among 5-Year Survivors of Childhood Cancer. New England Journal of Medicine. 2016; 374:833-842.


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