S1008
Clinical – Paediatric tumours
ESTRO 2026
National Research Institute of Oncology, Cracow, Poland. 3 I Radiotherapy Clinic, Maria Sk ł odowska-Curie National Research Institute of Oncology, Gliwice, Poland. 4 Department of Nuclear Medicine and Endocrine Oncology,, Maria Sk ł odowska-Curie National Research Institute of Oncology, Gliwice, Poland Purpose/Objective: Majority of children diagnosed with are cured with modern therapies, however due to aggressive treatment, many of them have late serious complications. Dedicated survivorship clinics for those A prospectively collected data about all consecutive adult patients who are survivors of childhood cancers admitted to dedicated clinic was analysed. Records of 210 patients were collected regarding their cancer status, co-morbidities and social aspects. Results: patients are lacking. Material/Methods: Since 2022, 210 patients (110 male, 100 female) were provided with multidisciplinary care. Median follow-up was 2 years (range 1-22 years) with 8.1% referred to continuation of the treatment in adult clinic, 5.3% with progression of primary tumour or second cancer diagnosis, 42.9% and 44.3% with less or more than 5- years of follow-up, respectively. Primary diagnosis included: brain tumours (33%), lymphoma (26%), leukaemia (14%), sarcoma (14%), testicular/ovary tumours (5%), renal tumours (4%) and others (3%). Second, third and fourth subsequent cancer were diagnosed in 13, 3 and 1 patient, respectively. Among all, 87% were cured from primary cancer. We provided a cardiologist, haematologist, pulmonologist, endocrinologist, and psychologist consultations in
The median age of the pediatric cohort was 10.1 years. In the CSI group, 13 patients had DIPG/DMG and 6 had supratentorial tumors, whereas the focal radiochemotherapy group included 16 patients with DIPG/DMG and 2 with supratentorial tumors. Median overall survival was 15 months (95% CI 4.8-25.5) in the craniospinal radiochemotherapy group and 9 months (95% CI 6-11.9) in the focal radiochemotherapy group (p<0.001 Fig. 1). Severe hematotoxicity (grade 3-4) occurred in 7 of 19 patients (36.8%) from the CSI cohort versus 6 of 19 cases (31.6%) with focal treatment (not significant). Concomitant chemotherapy was discontinued in two CSI-treated patients—one due to temozolomide-induced aplastic anemia (TIAA) and another due to thrombocytopenia. The remaining patients tolerated full-dose CSI with concurrent chemotherapy, experiencing manageable side effects and no unplanned radiotherapy interruptions. In the focal group, one patient died after 11 fractions of radiotherapy due to rapid tumor progression. Conclusion: Upfront craniospinal radiochemotherapy in pediatric patients with metastatic high-grade glioma was feasible and associated with manageable hematotoxicity comparable to focal treatment. Despite similar toxicity profiles, CSI demonstrated a significantly improved overall survival, suggesting potential therapeutic benefit in this high-risk population. Prospective evaluation of upfront CSI within controlled clinical trials is planned to confirm these findings. Keywords: Craniospinal Radiochemotherapy pedHGG
49%, 29%, 14%, 13% and 10% of our patients, respectively. Most of them (83%) had late
complications after cancer diagnosis or treatment with the most common: neurological (37%), endocrinologic (33%), orthopaedic (32%), psychological (31%), gastrointestinal (23%), visual (23%), genitourinary (including infertility – 22%), cardiac (22%), and dental issues (22%). The highest incidence of complications was diagnosed in survivors of brain tumours (68% had four or more co-morbidities), and 36.2% of the analysed group declared having four or more health issues. Disability was diagnosed in 51% of the group. Evaluating social aspects, we found that only 13% moved away from parents or started their own family and only 4% had children (including twins). Conclusion: Majority of childhood survivors suffer from chronic complications and require lifelong complex follow-up. Keywords: survivorship, childhood cancer, co- morbidities
Poster Discussion 2386 Long term follow-up of childhood cancer survivors:
second cancers and late complications Aleksandra Napieralska 1,2 , Katarzyna Drosik- Rutowicz 3,2 , Aleksandra Krol 4
1 Radiotherapy Department, Maria Sk ł odowska-Curie National Research Institute of Oncology, Gliwice, Poland. 2 Radiotherapy Clinic, Maria Sk ł odowska-Curie
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