FollowUp after the Completion of Therapy

First Year after Completion of Therapy

• Physical examination every 2 months

• Chest radiograph every 2 months

• Appropriate imaging studies (i.e., CT or MRI of the involved region) every 4 months

• Echocardiogram 1 year after completion of therapy to follow possible anthracy-cline cardiotoxicity (if indicated)

• Appropriate studies outlined below.

Second and Third Years after Completion of Therapy

• Physical examination every 4 months

• Chest radiograph every 4 months

• Appropriate studies outlined below.

Fourth to Tenth Years after Completion of Therapy

• Annual visit for physical examination and studies outlined below.

Ten Years after Completion of Therapy

• Maintain yearly visit or phone contact.

• Record attainment of puberty, offspring, and development of second malignancies.

General Studies

• Height and weight at 6-month intervals

• Annual BP measurements

• Tanner staging annually until stage V

• Testicular size annually

• Onset of menses in girls

• Patients who receive cyclophosphamide: evaluation of gonadal function (FSH, LH, and testosterone/estradiol).

Studies for Specific Sites

Head and Neck

• Annual growth measurements

• Annual ophthalmologic examination

• Annual dental examination.

Trunk

• Radiographs of irradiated bones every 1-2 years

• Kidney function, urinalysis, creatinine annually

• Sitting height/standing height ratio

• If patient received radiotherapy to chest or lungs, history of exercise intolerance or shortness of breath.

Genitourinary Sites

• Kidney function evaluation every 1-2 years

• Girls—follow-up of sexual maturation and ovarian function

• Boys—history regarding ejaculatory function, semen analysis.

Extremities

• Annual bilateral limb length measurements

• Radiographs of primary sites for bone growth abnormalities.

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