Treatment late effects in long-term survivors of pediatric sarcoma

Patrick Mansky, Andrew Arai, Pamela Stratton, Donna Bernstein, Lauren Long, James Reynolds, Donna Chen, Seth M. Steinberg, Neil Lavende, Karen Hoffman, Paul C. Nathan, Rebecca Parks, Elizabeth Augustine, Usha Chaudhry, Joanne Derdak, Lori Wiener, Lynn Gerber, Crystal Mackall

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose. To assess health and musculoskeletal function in survivors of pediatric sarcomas. Patients and Methods. Thirty-two individuals treated for Ewing sarcoma family of tumors (ESFT), rhabdomyosarcoma (RMS), or non-rhabdomyosarcoma soft tissue sarcomas (NR-STS) with multi-modality therapy were enrolled on this cross-sectional study. Median age at the time of therapy was 15.4 years (range 7.1-34.2), median age at the time of analysis was 37.4 years (17.5-55.4), and median duration of time elapsed from completion of therapy was 17.3 years (2.9-32.6). Participants underwent assessments of musculoskeletal functioning, cardiac function, metabolic and lipid analyses, renal and gonadal function, and psychological evaluation. Results. This cohort of sarcoma survivors shows expected locoregional limitations in function of the area affected by sarcoma, and impaired global musculoskeletal functioning as evidenced by limited endurance and limited overall activity levels. The cohort also demonstrated substantial rates of cardiac dysfunction, elevated body fat index, hyperlipiclemia, chronic psychological distress, and infertility in men (76%) and premature menopause (49%) in women. Conclusion. Sarcoma survivors demonstrate diminished locoregional and global musculoskeletal functioning which likely limit occupational opportunities and socioeconomic health. In addition, the combination of diminished cardiac reserve, limited activity levels, and lipid dysregulation in sarcoma survivors suggests that this population is at increased risk for cardiovascular disease, even many years following completion of sarcoma therapy. Sarcoma survivors may benefit from life long follow-up for cardiovascular disease and from occupational counseling upon completion of therapy.

Original languageEnglish (US)
Pages (from-to)192-199
Number of pages8
JournalPediatric Blood and Cancer
Volume48
Issue number2
DOIs
StatePublished - Feb 2007

Keywords

  • Cancer survivors
  • Cardiac
  • Infertility
  • Late effects
  • Musculoskeletal
  • Renal
  • Stress
  • Treatment

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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