International Journal of Hematology

, Volume 92, Issue 1, pp 95–104 | Cite as

Late effects and quality of life of childhood cancer survivors: Part 2. Impact of radiotherapy

  • Yasushi IshidaEmail author
  • Naoko Sakamoto
  • Kiyoko Kamibeppu
  • Naoko Kakee
  • Tsuyako Iwai
  • Shuichi Ozono
  • Naoko Maeda
  • Jun Okamura
  • Keiko Asami
  • Hiroko Inada
  • Misato Honda
  • Keizo Horibe
Original Article


To examine the late effects and health-related quality of life of childhood cancer survivors (CCS) after radiotherapy (RT), we performed a cross-sectional survey using self-rating questionnaires. The subjects were divided into 3 groups: CCS treated with or without RT, and a general population matched for age, gender, residential area, and work status. The numbers in each group were 113, 72, and 1,000, respectively. The median ages of CCS at diagnosis and the time of the survey were 8 and 22 years, respectively. The mean final heights of males and females were significantly lower in CCS with RT than in the other 2 groups. Risk factors for a short stature were total body irradiation (TBI) [odds ratio (OR) 17.8, p < 0.001], spinal irradiation (OR 8.31, p = 0.033), and an age younger than 10 years at diagnosis. Late effects were observed in 68% of CCS with RT compared with 36% of CCS without RT. Multivariate analysis revealed that TBI was significantly associated with endocrine dysfunction (OR 12.3), skull and spinal irradiation with cognitive dysfunction (OR 16.1 and 11.5, respectively), and spinal irradiation with a short stature (OR 14.1), respectively. Physical dysfunction, psychological stress, and problems of social adaptation were observed in >50% of CCS with RT.


Radiotherapy Radiation Late effects Childhood cancer survivors Quality of life 



The institutions that provided patient data and recruited CCS to the survey are listed in Table 1. This study was supported by research grants from the Japanese Ministry of Health, Labour and Welfare (Grant No. 18-14: “Study of quality of life and prognosis in childhood cancer survivors and establishment of a long-term follow-up system”).

Conflict of interest statement

The authors declare no financial interests.


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Copyright information

© The Japanese Society of Hematology 2010

Authors and Affiliations

  • Yasushi Ishida
    • 1
    • 10
    Email author
  • Naoko Sakamoto
    • 2
  • Kiyoko Kamibeppu
    • 3
  • Naoko Kakee
    • 4
  • Tsuyako Iwai
    • 5
  • Shuichi Ozono
    • 6
  • Naoko Maeda
    • 7
  • Jun Okamura
    • 8
  • Keiko Asami
    • 9
  • Hiroko Inada
    • 6
  • Misato Honda
    • 10
  • Keizo Horibe
    • 7
  1. 1.Department of PediatricsSt. Luke’s International HospitalTokyoJapan
  2. 2.Department of EpidemiologyNational Research Institute for Child Health and DevelopmentTokyoJapan
  3. 3.Department of Family NursingThe University of TokyoTokyoJapan
  4. 4.Department of Health PolicyNational Research Institute for Child Health and DevelopmentTokyoJapan
  5. 5.Department of Hemato-oncologyKagawa Children’s HospitalKagawaJapan
  6. 6.Department of PediatricsKurume University School of MedicineFukuokaJapan
  7. 7.Department of Pediatrics and Clinical Research CenterNagoya Medical CenterAichiJapan
  8. 8.Institute for Clinical Research, National Kyusyu Cancer CenterFukuokaJapan
  9. 9.Department of PediatricsNiigata Cancer Center HospitalNiigataJapan
  10. 10.Department of PediatricsEhime University Graduate School of MedicineToonJapan

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