Oppdages de fleste residivene av malign solid svulst hos barn gjennom avtalte radiologiske kontroller eller på grunnlag av akutte somatiske symptomer?

Abstract

ABSTRACT Purpose: Children with a solid malignant tumor are followed up with regular check-ups to discover any relapses or side effects of their treatment. These check-ups include imaging that lasts up to a minimum of five years after ended treatment. A lot of resources are used in these check-ups. Our purpose was to discover if these relapses were caught mainly through routine check-ups or if acute symptoms lead to the diagnosis. Material/method: This is a retrospective study of patients with solid malignant tumors who were between 0-16 years old, diagnosed between 01.01.2005-31.12.2009 at Rikshospitalet and Oslo University hospital. All patients were followed up here. We defined relapse as “ increased cancer activity after remission during or after ended therapy that required further treatment”. Results/conclusion: A total number of 44 patients had a relapse in this study. 25 patients were discovered through a routine check-up, and 7 of these patients also had symptoms at the time. Total 19 patients where diagnosed with relapse in between these check-ups based on symptoms. A total number of 26 patients had symptoms during diagnosis of their relapse. Most (80%) of the relapses occurred within the first two years after the initial cancer diagnosis. Two patients had a relapse after 5 years. The survival rate among the patients who were diagnosed with relapse through a routine check-up was 40% (10/44) and 42% (8/19) among patients who were diagnosed with a relapse due to acute symptoms in between check-ups. Statistics significance is not calculated. Based on our findings we can wonder if some of the imaging used in these frequent routine check-ups can be replaced by only clinical examinations, given the fact that imaging may be done without delay if necessary.