Musculoskeletal sequelae of childhood bone sarcoma survivors

Abstract

Background. Childhood solid tumor survivors are known to be at risk for serious musculoskeletal late effects that may result in disability, associated with multicomponent antitumor treatment. Aims. To improve the quality of life of childhood bone sarcoma survivors. Materials and methods. Forty-six children and adolescents (22 males, 24 females) were treated for primary bone sarcomas (follow-up, 22216 months). Mean age at orthopedic diagnosis was 15.09 years (range, 623 years). Treatment consisted of neoadjuvant chemotherapy and radiotherapy of the initial tumor and metastasis left after induction and/or oncologic surgery and adjuvant chemotherapy. We used the NCI Common Terminology Criteria for Adverse Events for reporting. Results. The most common grade of late effects observed was grade 2 (91 cases). We observed serious adverse events, that is, grade 4 (life-threatening consequences) in five cases and grade 5 (death related to adverse events) in one. A total of 32 orthopedic patients had fewer than six late effects, while 14 had more than six late effects. Conclusions. The development of musculoskeletal sequelae is unavoidable in the majority of the survivors due to the need to use them in very aggressive treatment strategies leading to a significant increase in survival. Early diagnosis and orthopedic correction of adverse effects are necessary to ensure an acceptable quality of life and good social adaptation of patients.