Transition in der pädiatrischen Onkologie – Langzeitnachsorge und Spätfolgen nach Krebserkrankung im Kindes- und Jugendalter

Background: About 80% of children and adolescents with cancer are nowadays cured. However, depending on the type of cancer and its treatment, many of these patients are at risk of developing chronic health conditions. If these late effects occur decades after the end of therapy, these patients are already adults and no longer in regular pediatric oncological care. Objective: The most frequent late effects of childhood cancer treatment are presented in this review. Moreover, difficulties with the transition of these patients and interdisciplinary models of care in Germany are discussed. Results: Studies on long-term survivors demonstrate that late effects following childhood cancer treatment occur in an increasing number of patients. These sequelae may affect different organs and, if detected early, are often highly treatable. Therefore, life-long follow-up is recommended, which has to be continued after the end of oncological aftercare. Conclusion: A successful transition of long-term childhood cancer survivors constitutes a special challenge, as it has to ensure transition from pediatric to internal medicine care as well as a change in the focus of care, shifting from relapse-centered follow-up to late effects-centered surveillance. The recommended follow-up investigations can be offered in specialized late effects clinics to facilitate early diagnosis and treatment of sequelae.