LATE EFFECTS OF THERAPY IN SURVIVORS OF EWINGS-SARCOMA FAMILY TUMORS

Purpose: This late effects study was designed to determine if survivor s of Ewing's sarcoma family tumors (ESFT) had adverse outcomes in empl oyment, marital status, fertility, and functional status when compared to sibling controls. Subjects and methods: Eighty-nine survivors (cas e subjects) of ESFT treated at the National Cancer Institute between 1 965 and 1992 and 97 sibling controls completed a questionnaire probing aspects of quality of life. The answers from case subjects were compa red to pooled and matched sibling controls for all key variables. Odds ratios (OR) and p values from pooled analyses are presented. Results: Although case subjects and controls did not differ in educational ach ievement, case subjects wen less likely to be employed full-time (OR 0 .4, p<0.01), to be married (OR 0.2, p<0.01), and to have children (OR 0.3, p<0.01). Their most common treatment-related difficulties include d permanent hair and skin changes (43%), lung problems (18%), neurolog ic problems (14%), visual difficulties (10%), second malignancy (7%), and amputation (5%). Functional status, measured by Karnofsky performa nce scale, was also adversely affected in case subjects. Case subjects did not differ from sibling controls in health care insurance status or in utilization of health services. Conclusions: important aspects o f life such as employment, marital status, fertility, and functional s tatus are affected in survivors of ESFT. More studies are needed to be tter define the health status of adult survivors of pediatric cancer a nd the impact of cancer in adolescence on psychosocial development.