Long-Term Outcomes And Late Effects In Survivors Of Childhood And Adolescent-Young Adult Cancers: An Institutional Perspective
Keywords:
Childhood cancer survivors, Late effects, Survivorship care, Quality of life, Endocrine dysfunctionAbstract
Background: Advances in multimodal therapy have markedly improved survival among children and adolescents with cancer.
However, increased survival has resulted in a rising burden of late effects that significantly impact long-term quality of life. Structured
survivorship care remains limited in India, and region-specific data on late effects are scarce. This study aimed to evaluate the prevalence,
spectrum, and determinants of late and long-term effects among childhood and adolescent–young adult (AYA) cancer survivors at a
tertiary center in Central India and to compare findings with national and international cohorts.
Methods: This ambispective study was conducted at the Department of Medical Oncology, Sri Aurobindo Institute of Medical
Sciences (SAIMS), Indore, from January 2014 to December 2023. Fifty survivors aged 2–39 years at diagnosis, with at least two
years since treatment completion, were assessed using CTCAE v5.0 criteria. Demographic, clinical, and treatment-related parameters
were analyzed using SPSS v26.0, applying Chi-square tests with p < 0.05 considered significant.
Results: The cohort included 50 survivors with a median follow-up of 8 years. Hematological malignancies constituted 62%, and
males were slightly predominant (52%). Late and long-term effects were present in 24 survivors (48%), with significant associations
with gender (p = 0.010), type of malignancy (p = 0.016), adverse effects during treatment (p = 0.028), duration of treatment (p =
0.024), and time since completion of therapy (p = 0.007). Endocrine dysfunction (30%), psychosocial morbidity (22.5%), hematologic
toxicity (20%), and cardiac complications (10%) were most commonly observed.
Conclusion: Nearly half of survivors experienced late effects, indicating the need for structured, multidisciplinary survivorship care
models, early screening, and telehealth-based follow-up to improve long-term outcomes and quality of life, particularly in resourcelimited
settings.
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