Psychosocial interventions for childhood cancer survivors: Systematic review and meta-analysis of randomized control trials

The Mechanism by 18 RCTs Psychosocial Interventions Affect the Personality, Emotions, and Behaviours of Paediatric and Young Adult Cancer Patients: A Systematic Review

Background/Objectives: Psychosocial interventions bring mental and social benefits to paediatric and young adult patients. Gaining insight into the optimal psychosocial intervention strategies and their process mechanisms can contribute to the deepening of practice in this field. Methods: This systematic review evaluates the psychosocial interventions that promote adaptability, resilience, and positive changes among paediatric and young adult patients. Following the Cochrane guidelines, the literature from 2000 to 2024 was reviewed, focusing on randomised controlled trials (RCTs). Results: Eighteen studies were included and analysed using a logic model framework. Therapeutic interventions that involved the reframing of cognition activities shaped personality changes, including resilience and adaptation, requiring significant investment, and they were influenced by individual characteristics and background. Process-oriented activities, such as art-, play-, and music-based therapies, improved emotional well-being and were affected by pain, cognitive abilities, and language skills. Behavioural changes are best achieved through interactive interventions, particularly group-based and parent-involved approaches, which improve social integration and physical abilities. Conclusions: Psychosocial interventions lead to positive changes in paediatric and young adult patients in terms of personality, emotion, and behaviour. Although the sample size for the behavioural changes is insufficient, understanding the mechanisms underlying these interventions benefits practice.

Health-related Quality of Life in children and adolescents treated for acute lymphoblastic leukaemia (ALL), compared with healthy peers: a longitudinal study of early survivorship

PURPOSE

Survival for childhood Acute Lymphoblastic Leukaemia (ALL) has surpassed 90%, making quality of survival an important endpoint in treatment outcomes. This study examined health-related quality of life (HRQoL) trajectories in early survivorship for patients post-ALL treatment compared with a matched group of healthy peers, and explored the association of individual factors (age, sex) and treatment intensity with HRQoL outcomes.

METHODS

Eighty-three paediatric patients aged 4-16 years who recently completed treatment for ALL were recruited to the study, alongside 53 age- and sex-matched healthy children. All participants completed the self-report Pediatric Quality of Life Inventory (PedsQL) generic score scale at 3-, 15- and 27-months post-study enrolment.

RESULTS

Trajectory of overall HRQoL for the patient group declined over time, falling below clinical cutoffs at 27 months. Subscale trajectories differed between groups, with patients' emotional and social functioning negatively diverging relative to healthy peers, while school functioning remained consistently reduced. Children treated for ALL experienced significantly poorer HRQoL compared to healthy peers at 27 months post-treatment (p = 0.027, ES = - 0.47) with moderate effect sizes, reflecting lower social functioning (p = 0.044, ES = - 0.42) and school functioning (p = 0.011, ES = - 0.52). Age and sex were not associated with overall HRQoL at 27 months; however, younger age was associated with reduced emotional functioning in the standard treatment-intensity group.

CONCLUSION AND IMPLICATIONS

HRQoL is impaired in children treated for ALL in early survivorship, particularly across social and school functioning domains. Screening using patient-reported outcomes is reliable at identifying young people at risk and has potential to guide psychosocial interventions in this early off-treatment period.