Late effects after therapy of childhood cancer

Since two thirds pediatric cancer patients can be cured of their disease, t he recognition and treatment of late effects of therapy have become increas ingly important. Most of these patients will pass the different stages of n ormal development having survived cancer in childhood. Knowledge of the nor mal child-adolescent development is one of the requirements for the long-te rm care of survivors of childhood cancer. In this manuscript we depict the known main risk factors for the late toxicity of different organs. The iden tification of risk factors was based on a survey of the literature. A main cause for late effects is radiation therapy. In addition there is an increa sed risk of sequelae for solid tumors versus hematologic malignancies. Acco rding to the definition of risk factors, indications for a specific diagnos tic program are determined. We recommend an individualized schedule for fol low-up depending upon the presence of these risk factors. With this diagnos tic program presented it should be possible to diagnose known relevant late effects, thus preventing excessive medical attention for the patients and limiting the diagnostic efforts and costs for the physicians taking care of each patient.