Abstract
From January 2003 a long term follow-up project started for adult patients treated in our Centre for cancer in pediatric age, to evaluate late effects of therapy. For all patients a personalized follow-up was scheduled (time, function-tests, etc).
We analyzed 24 cases of bone tumors: 14 osteosarcoma (OS) and 10 Ewing’s sarcoma (ES). Median age at diagnosis was 13 years (range 11–18) for OS patients, 11.6 years (range 6–18) for ES; 50% males in both groups. All patients were treated according current CNR/ISG-protocols: all OS cases underwent surgery; in 5/10 ES patients local treatment was surgery, in 5/10 radiotherapy; 7/24 received hematopoietic stem cells transplantation (HSCT).
Median age at evaluation is respectively 26.5 years (range 18.7–34) and 23.5 (range 21.6–32); median follow-up is 13 years (range 6–22) and 13.7 (range 6.7–22.3).
Cardiovascular function is normal in all OS cases; 3/10 ES patients developed asymptomatic ejection fraction reduction, currently not treated.
One OS patient underwent bilateral thoracotomy and HSCT for multiple metastases at diagnosis and had a mild lung function alteration. One OS patient developed mild chronic kidney disease, one ES nephrolithiasis. Liver function is normal in all cases.
Height velocity and final height are normal in 10/14 OS and 9/10 ES patients; in remaining 5/24 no growth hormone secretion deficit was found.
One OS patient developed primitive hypothyroidism and one OS benign thyroid nodule with partial thyroidectomy; one patient multifocal papillary thyroid carcinoma with total thyroidectomy at 11 years from diagnosis of ES.
Spermatogenesis deficit is a common find (5/7 OS and 5/5 ES male patients); one female treated with HSCT and radiotherapy for ES pelvic relapse has primitive hypogonadism. No other hypothalamo-hypophyseal-adrenocortical system hormones deficit was found.
We reported no significant neuropsychological alterations nor employment problems: 20/24 patients have a job, 4/24 are students. Three OS females have children.
Correspondence should be addressed to Professor Stefan Bielack, Olgahospital, Klinikum Stuttgart, Bismarkstrasse 8, D-70176 Stuttgart, Germany. Email: s.bielack@klinikum_stuttgart.de
