AbstractsMedical & Health Science

With improved survival rates, childhood cancer survivors are confronted with treatment-related adverse events, especially when radiation therapy was involved. After the introduction (Chapter 1), the Chapters 2 and 3 present the EKZ/AMC childhood cancer survivor cohort and the methodology of using the equivalent dose in 2-Gy fractions (EQD2), which is considered a novel approach in epidemiological studies on late effects. In four cohort studies adverse events are analyzed in relation to the EQD2, also considering other treatment-related risk factors. Chapter 4 focuses on one diagnosis and evaluated late effects in long-term Wilms’ tumor survivors, as such a subcohort of the EKZ/AMC cohort. In Chapter 5 the dose-effect relationships for adverse events after cranial radiation therapy were analyzed. This study included the complete cohort, thus comprising a wide variety of diagnoses. This was also the case in Chapter 6, in which cerebrovascular events including stroke and TIA (i.e. transient ischemic accident) have been studied. Chapter 7 presents the study on valvular abnormalities detected by echocardiography in childhood cancer survivors treated with potentially cardiotoxic therapy. Chapter 8 includes the protocol of the Cochrane Systematic Review on breast cancer in female survivors who had received radiotherapy involving the chest for their primary malignancy. The actual review is currently in progress. The thesis concludes with a summary and general discussion in chapter 9.