Late deaths following radiotherapy for pediatric tumors

From 1953 to 1975, 341 children received megavoltage radiation and survived at least 5 years. Chemotherapy was administered to 189 of these children. Although the expected age-adjusted 30-year survival was 97%, the observed survival was only 83%. Late recurrence of primary tumor was responsible for 24 of 37 deaths. Other causes of death included second neoplasm (4 patients), infection (4 patients), central nervous system complication (2 patients), inanition (1 patient), motor vehicle accident (1 patient), and miscellaneous (1 patient). Thus, 36 of the 37 late deaths were secondary to either the original cancer, a new cancer, or the effects of treatments. Brain tumors and Ewing's sarcoma have more late deaths while neuroblastomas have fewer late deaths than expected. Even after 25 years of follow-up, the survival of this cohort does not parallel that of the general population.