gms | German Medical Science

27th German Cancer Congress Berlin 2006

German Cancer Society (Frankfurt/M.)

22. - 26.03.2006, Berlin

Long-term toxicity in adulthood after childhood cancer

Meeting Abstract

  • corresponding author presenting/speaker Thorsten Langer - Kinder- und Jugendklinik, Universitätsklinikum Erlangen, Deutschland
  • Marios Paulides - Kinder- und Jugendklinik, Universitätsklinikum Erlangen
  • Wolfgang Stöhr - Kinder- und Jugendklinik, Universitätsklinikum Erlangen
  • Jörn-Dirk Beck - Kinder- und Jugendklinik, Universitätsklinikum Erlangen

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocIS068

The electronic version of this article is the complete one and can be found online at:

Published: March 20, 2006

© 2006 Langer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Late effects of cancer therapy play a growing role in the evaluation of the outcome of oncology therapy trials. They are of utmost relevance for those patient groups with good long-term prognosis and life expectancy such as survivors of childhood cancer. It has been estimated that as many as one in 250 persons may be a childhood cancer survivor in the year 2010. Long-term toxicity from cancer treatment may develop as late as 15-20 years after the therapy and often presents itself acutely. Therefore, long-term follow-up is essential for the diagnosis of subclinical impairments and the planning of interventions to try to limit progression to overt disease. Especially for sarcoma patients, since 1998 we have established a vertical network within the Late Effects Surveillance System of the German Society for Pediatric Oncology and Hematology (GPOH) that registers the results of standardized follow-up examinations in patients treated within the sarcoma therapy trials of the GPOH COSS-96, CWS-96/CWS-2002P, EICESS-92/EURO-E.W.I.N.G.-99 and monitors for sequelae of treatment. Within this cohort of soft tissue-, Ewing’s and osteosarcoma patients of all ages, a similar spectrum of therapy-related sequelae has been observed when comparing patients with diagnosis at <21 years (pediatric collective) and patients with diagnosis at >21 years (adult patients). Thus, incidence rates are not affected by patients progressing into adulthood with longer follow-up. In the adult collective there have been found cumulative incidence rates for the major sequelae of sarcoma therapy of 4.2% for cardiotoxicity, 1.2% for nephrotoxicity and 23.2% for hearing loss. These incidence rates show an overall moderate rate of toxicity in the adult collective, which are lower than those found in the pediatric collective of 7.5%, 4.6% and 52% respectively. Therefore, cancer treatment-related toxicities are age dependent. It is very important to be aware of this difference when following-up childhood cancer survivors as they might show subclinical impairments more often, which could decompensate in adulthood unless adequate intervention is taken. An adequate long-term follow-up, such as outlined in the LESS-guidelines of the GPOH, is essential for the diagnosis of long-term toxicity in adulthood after childhood cancer.