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Clinical Trial Enrollment is Associated With Improved Follow-up Rates Among Survivors of Childhood Cancer

Hutchins, Kelley K., DO, MPH*,†; Savaşan, Süreyya, MD*,†; Thomas, Ronald L., PhD*; Strathdee, Laura A., MA*; Wang, Zhihong J., MD, PhD*,†; Taub, Jeffrey W., MD*,†

Journal of Pediatric Hematology/Oncology: January 2019 - Volume 41 - Issue 1 - p e18–e23
doi: 10.1097/MPH.0000000000001169
Online Articles: Original Articles

Fortunately >80% of children diagnosed with cancer become long-term survivors; however, this population is at a significantly increased risk of morbidity and mortality as a result of their previous cancer therapy, and long-term follow-up (LTFU) is critical. Multiple barriers to receiving adequate LTFU care have been studied. We investigated whether lack of enrollment in a therapeutic clinical trial may be a barrier to receiving LTFU care. We conducted a review of 353 patient records at the Children’s Hospital of Michigan enrolled in our Children’s Oncology Group registry between January 1, 2005 and December 31, 2010. In total, 71 patients were excluded (death before follow-up, n=61; currently receiving therapy, n=5; known transfer of care, n=4; insufficient information, n=1). In total, 158 (56%) patients were enrolled in a therapeutic clinical trial. Follow-up rates at 1-, 2- and 5-years following completion of therapy for patients enrolled in a therapeutic clinical trial were 96.8% (153/158), 93.7% (148/158), and 81.7% (103/126), respectively, compared with 83.1% (103/124; P<0.001), 74.2% (92/124; P<0.001), and 66.7% (72/108; P=0.001) for patients not enrolled. Our findings suggest patients enrolled in a therapeutic clinical trial have better LTFU rates and supports the importance of patient enrollment in therapeutic clinical trials when possible. Additional resources may be warranted to improve LTFU for patients not enrolled.

*Carman and Ann Adams Department of Pediatrics, Division of Hematology/Oncology, Children’s Hospital of Michigan, Wayne State University School of Medicine

Barbara Ann Karmanos Cancer Center, Detroit, MI

The authors declare no conflict of interest.

Reprints: Kelley K. Hutchins, DO, MPH, Carman and Ann Adams Department of Pediatrics, Division of Hematology/Oncology, Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien St., Detroit, MI 48201 (e-mail: khutchin@dmc.org).

Received January 11, 2018

Accepted March 8, 2018

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