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Herzog K, Schepper F, Pletschko T, Herrmann J, Budich M, Christiansen H, Suttorp M, Martini J. Illness perceptions, fear of progression and health-related quality of life during acute treatment and follow-up care in paediatric cancer patients and their parents: a cross-sectional study. BMC Psychol 2023; 11:44. [PMID: 36782336 PMCID: PMC9926758 DOI: 10.1186/s40359-023-01078-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND This study examines the role of illness perceptions and fear of progression (FoP) in paediatric cancer patients and their parents for patient's health-related quality of life (HRQoL), controlling for sociodemographic and medical variables. 4-18-year-old patients in acute treatment or follow-up care and one parent were examined. METHODS N = 46 patient-parent dyads in acute treatment and n = 84 dyads in follow-up care completed measures on illness perceptions (Illness-Perceptions-Questionnaire for 12-18-year-old patients and parents or as age-adapted puppet interview for 4-11-year-old patients) and FoP (Fear-of-Progression-Questionnaire for 7-18-year-old patients and parents). Patients also completed the KINDL-R to measure HRQoL. Hierarchical multiple regression analyses were calculated. RESULTS In acute treatment, patient's perceptions of symptoms and cyclicity of their illness explained variation in their HRQoL in addition to sociodemographic and medical variables. In follow-up care, patient's FoP and parent's perception of consequences explained additional variation in patient's HRQoL. Overall, sociodemographic and medical variables explained less variation in HRQoL in follow-up care than in acute treatment. CONCLUSIONS Our results stress the importance of psychological factors for the well-being of paediatric cancer patients, particularly in follow-up care, where sociodemographic and medical variables play a lesser role. We recommend screening for illness perceptions and FoP during and after acute treatment to support patients and parents. Furthermore, standardized interventions focussed on changing maladaptive illness perceptions should be developed and evaluated. As parents' perceptions, thoughts, and feelings may also play an important role for the well-being of the patients, interventions should be family-focussed and include parents. Trial registration The study has been pre-registered at the German Clinical Trials Register (registered 30/06/2020; DRKS00022034) and at the Open Science Framework ( https://osf.io/3uwrx ).
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Affiliation(s)
- Kristina Herzog
- Department of Psychiatry and Psychotherapy, Faculty of Medicine of the Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany. .,Department of Paediatric Oncology, Haematology and Haemostaseology, Leipzig University, Leipzig, Germany.
| | - Florian Schepper
- grid.9647.c0000 0004 7669 9786Department of Paediatric Oncology, Haematology and Haemostaseology, Leipzig University, Leipzig, Germany
| | - Thomas Pletschko
- grid.22937.3d0000 0000 9259 8492Department of Paediatric and Adolescent Medicine, Medical University Vienna, Vienna, Austria
| | - Jessy Herrmann
- Elternhilfe für krebskranke Kinder e.V. Leipzig, Leipzig, Germany
| | - Mihaela Budich
- grid.412282.f0000 0001 1091 2917Department of Paediatrics, Paediatric Haematology and Oncology, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Holger Christiansen
- grid.9647.c0000 0004 7669 9786Department of Paediatric Oncology, Haematology and Haemostaseology, Leipzig University, Leipzig, Germany
| | - Meinolf Suttorp
- grid.4488.00000 0001 2111 7257Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Julia Martini
- grid.4488.00000 0001 2111 7257Department of Psychiatry and Psychotherapy, Faculty of Medicine of the Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
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Tardy F, Casagranda L, Protiere A, Buisson-Papet G, Garcin A, Trombert-Paviot B, Freycon C, Marec-Berard P, Massoubre C, Berger C. Long-Term Clinical and Psychiatric Complications of Young Adults Cured of a Pediatric Bone Tumor Diagnosed Between 1987 and 1999 in Rhône: Alpes Region (France). J Adolesc Young Adult Oncol 2022; 11:571-579. [PMID: 35049375 DOI: 10.1089/jayao.2021.0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose: The 5-year survival for children diagnosed with cancer is ∼85%. The constant increase in survival curves is evidence of therapeutic optimization. Clinical and psychological complications are rarely analyzed simultaneously in the literature for pediatric malignant bone tumors. We aimed to describe different clinical and psychiatric sequelae and to evaluate the quality of life (QoL) of adults followed for a pediatric bone tumor. Methods: The Association of the Childhood Cancer Registry in Rhône-Alpes Region has coordinated two long-term follow-up studies designed to evaluate complications of childhood cancer. Only bone tumors are analyzed. Patients were given a self-questionnaire, followed by a clinical consultation then a psychological interview. Results: Twenty-five patients were studied. The mean age at diagnosis was 11.3 years. The median follow-up time was 20.7 years. Of the patients, 66.7% had at least one psychiatric disorder versus 31.9% in the general population (p = 0.0006). Comparing with the general population, 47.6% have at least one mood disorder (p < 0.001), 52.4% have at least one anxiety disorder (p = 0.0035), and 28.6% have an addiction (p < 0.0001). The mean number of clinical sequelae per patient was 3.12. Ninety-six percent of the patients studied had at least one clinical sequela. The overall QoL score was 59.7 with a physical score of 60.5 and a mental score of 52.9. All domains considered were lower for these patients. Conclusion: It is essential to offer psychological support from the time of diagnosis to limit the risk of developing an addiction. Clinical Trial numbers: NCT01531478 and NCT02675166.
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Affiliation(s)
- Faustine Tardy
- Department of Pediatric Hematology and Oncology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Léonie Casagranda
- Department of Pediatric Hematology and Oncology, University Hospital of Saint-Etienne, Saint-Etienne, France.,University of Lyon, Jean Monnet University, INSERM, U1059, Sainbiose, Saint-Etienne, France
| | - Alice Protiere
- Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Gaelle Buisson-Papet
- Department of Pediatric Hematology and Oncology, University Hospital of Grenoble, Grenoble, France
| | - Arnauld Garcin
- Department of Clinical Research and University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Béatrice Trombert-Paviot
- Department of Public Health and Medical Informatics, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Claire Freycon
- Department of Pediatric Hematology and Oncology, University Hospital of Grenoble, Grenoble, France
| | - Perrine Marec-Berard
- Department of Pediatric Oncology, Pediatric Hematology and Oncology Institute, Lyon, France
| | - Catherine Massoubre
- Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Claire Berger
- Department of Pediatric Hematology and Oncology, University Hospital of Saint-Etienne, Saint-Etienne, France.,University of Lyon, Jean Monnet University, INSERM, U1059, Sainbiose, Saint-Etienne, France
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Weber DC, Beer J, Kliebsch UL, Teske C, Baust K, Walser M, Pica A, Bachtiary B, Timmermann B, Calaminus G. Quality-of-life evaluations in children and adolescents with Ewing sarcoma treated with pencil-beam-scanning proton therapy. Pediatr Blood Cancer 2022; 69:e29956. [PMID: 36052578 DOI: 10.1002/pbc.29956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND With improved survival rates for children with cancer, quality-of-life (QoL) issues have increasingly become the focus of attention. We report the QoL of children with Ewing sarcoma (EWS) treated with pencil-beam-scanning proton therapy (PT). METHODS A PEDQOL (QoL questionnaire for children 4-18 years) self/proxy questionnaire was used to prospectively assess the QoL of 23 children <18 years with EWS treated with PT. This questionnaire evaluates eight different domains. Children (self-rating) and parents (proxy-rating) filled out the questionnaire at the start of PT (E1), 2 months after treatment (E2), and thereafter once yearly (E≥3). RESULTS Compared with healthy controls, parents rated the QoL of their children at E1 significantly worse in all but two (cognition and social functioning-family) domains. At E4, significant differences between the two groups only remained in three of eight domains. At E1, children self-rated their QoL significantly worse in the domain Physical functioning (p = .004) and significantly better in the domain Body image (p = .044) compared to healthy controls, whereas no significant differences were observed at E4. For the longitudinal comparison E1 versus E4, according to parents, Emotional functioning, Cognition and Social functioning-peers were slightly decreased 2 years after PT. The children rated Emotional functioning and Body image poorly 2 years after PT. CONCLUSIONS Children with EWS usually recovered seemingly well to normal QoL levels 2 years after the end of PT. They tended to rate their QoL substantially higher than their parents. However, in the longitudinal analysis at 2 years, children rated their Emotional functioning and Body image scores poorly.
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Affiliation(s)
- Damien C Weber
- Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, Villigen West, Switzerland.,Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of Radiation Oncology, University Hospital of Zürich, Zürich, Switzerland
| | - Jürgen Beer
- Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, Villigen West, Switzerland.,Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ulrike L Kliebsch
- Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, Villigen West, Switzerland
| | - Carmen Teske
- Department of Pediatric Hematology and Oncology, Working group Quality of Life, University Hospital Bonn, Bonn, Germany
| | - Katja Baust
- Department of Pediatric Hematology and Oncology, Working group Quality of Life, University Hospital Bonn, Bonn, Germany
| | - Marc Walser
- Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, Villigen West, Switzerland.,Department of Radiation Oncology, Zentralklinik Bad Berka, Bad Berka, Germany
| | - Alessia Pica
- Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, Villigen West, Switzerland
| | - Barbara Bachtiary
- Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, Villigen West, Switzerland
| | - Beate Timmermann
- Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen (WPE), West German Cancer Centre (WTZ), German Cancer Consortium (DKTK), Essen, Germany
| | - Gabriele Calaminus
- Department of Pediatric Hematology and Oncology, Working group Quality of Life, University Hospital Bonn, Bonn, Germany
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Glucocorticosteroid and Silicone Gel During Patch Application Without Clinical Scar Improvement After Central Venous Catheter Removal: A Randomized Trial. J Pediatr Hematol Oncol 2022; 44:e988-e993. [PMID: 35972834 DOI: 10.1097/mph.0000000000002517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 06/02/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We studied whether glucocorticosteroid during patch occlusion has a beneficial effect on scar outcome in children and adolescents treated for cancer. METHODS A double-blinded placebo-controlled randomized clinical trial was performed. The main outcome was the Vancouver Scar Scale. Secondary outcomes were scar width and scar quality measured using the Patient and Observer Scar Assessment Scale. The patients were divided into an intervention groups and a control group. The intervention group was randomized into active and placebo group. The active treatment consisted of cream with glucocorticosteroid and fusidic acid. The placebo treatment consisted of cream with fusidic acid. Both groups received silicone gel patch after central venous catheter removal. The control group received no specific skin care. RESULTS Assessment at 12 months showed that the intervention group had a significantly lower Vancouver Scar Scale and a smaller scar (0,1 cm) compared with the control group ( P =0.00, P =0.02) but no benefit of glucocorticosteroid. The Patient and Observer Scar Assessment Scale showed no significant difference between the intervention and control groups ( P =0.84, P =0.36). CONCLUSIONS Silicone gel sheet alone or in combination with application of glucocorticosteroid during sheet occlusion does not clinically improve scar outcome after removal of central venous catheter in children treated for neoplastic diseases.
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Herzog K, Schepper F, Kamm R, Engelhardt‐Lohrke C, Kreisch A, Pletschko T, Hauer J, Christiansen H, Suttorp M, Kiel J, Martini J. Illness perceptions in patients and parents in paediatric oncology during acute treatment and follow‐up care. Psychooncology 2022; 31:950-959. [DOI: 10.1002/pon.5883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Kristina Herzog
- Department of Psychiatry and Psychotherapy Faculty of Medicine of the Technische Universität Dresden Germany
- Department of Paediatric Oncology Haematology and Haemostaseology Leipzig University Germany
| | - Florian Schepper
- Department of Paediatric Oncology Haematology and Haemostaseology Leipzig University Germany
| | - Remo Kamm
- Sonnenstrahl e.V. Dresden – Förderkreis für krebskranke Kinder und Jugendliche Germany
| | | | - Andrea Kreisch
- Department of Paediatrics Paediatric Haematology and Oncology University Hospital Carl Gustav Carus Dresden Germany
| | - Thomas Pletschko
- Department of Paediatric and Adolescent Medicine Medical University Vienna Austria
| | - Julia Hauer
- Department of Paediatrics Paediatric Haematology and Oncology University Hospital Carl Gustav Carus Dresden Germany
| | - Holger Christiansen
- Department of Paediatric Oncology Haematology and Haemostaseology Leipzig University Germany
| | - Meinolf Suttorp
- Faculty of Medicine of the Technische Universität Dresden Germany
| | - Julia Kiel
- Department of Psychiatry and Psychotherapy Faculty of Medicine of the Technische Universität Dresden Germany
| | - Julia Martini
- Department of Psychiatry and Psychotherapy Faculty of Medicine of the Technische Universität Dresden Germany
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Roick J, Berner R, Bernig T, Erdlenbruch B, Escherich G, Faber J, Klein C, Bochennek K, Kratz C, Kühr J, Längler A, Lode HN, Metzler M, Müller H, Reinhardt D, Sauerbrey A, Schepper F, Scheurlen W, Schneider D, Schwabe GC, Richter M. Social inequalities in the participation and activity of children and adolescents with leukemia, brain tumors, and sarcomas (SUPATEEN): a protocol for a multicenter longitudinal prospective observational study. BMC Pediatr 2020; 20:48. [PMID: 32005112 PMCID: PMC6995139 DOI: 10.1186/s12887-020-1943-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 01/23/2020] [Indexed: 01/07/2023] Open
Abstract
Background About 2000 children and adolescents under the age of 18 are diagnosed with cancer each year in Germany. Because of current medical treatment methods, a high survival rate can be reached for many types of the disease. Nevertheless, patients face a number of long-term effects related to the treatment. As a result, physical and psychological consequences have increasingly become the focus of research in recent years. Social dimensions of health have received little attention in health services research in oncology so far. Yet, there are no robust results that allow an estimation of whether and to what extent the disease and treatment impair the participation of children and adolescents and which factors mediate this effect. Social participation is of great importance especially because interactions with peers and experiences in different areas of life are essential for the development of children and adolescents. Methods Data are collected in a longitudinal, prospective, observational multicenter study. For this purpose, all patients and their parents who are being treated for cancer in one of the participating clinics throughout Germany will be interviewed within the first month after diagnosis (t1), after completion of intensive treatment (t2) and half a year after the end of intensive treatment (t3) using standardized questionnaires. Analysis will be done by descriptive and multivariate methods. Discussion The results can be used to identify children and adolescents in high-risk situations at an early stage in order to be able to initiate interventions tailored to the needs. Such tailored interventions will finally reduce the risk of impairments in the participation of children and adolescents and increase quality of life. Trial registration ClinicalTrials.gov: NCT04101123.
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Affiliation(s)
- Julia Roick
- Institute of Medical Sociology (IMS), Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany.
| | - Reinhard Berner
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Toralf Bernig
- Department of Pediatrics, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Bernhard Erdlenbruch
- Johannes Wesling Klinikum Minden, University Hospital for Children and Adolescents, Ruhr University Hospital, Bochum, Germany
| | - Gabriele Escherich
- Clinic of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jörg Faber
- Children's Hospital, Pediatric Hematology, Oncology and Hemostaseology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Christoph Klein
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Konrad Bochennek
- Department of Pediatric Hematology and Oncology, University Hospital, Frankfurt/Main, Frankfurt, Germany
| | - Christian Kratz
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Joachim Kühr
- Clinic for Children and Adolescent Medicine, Klinikum Karlsruhe, Karlsruhe, Germany
| | - Alfred Längler
- Department of Integrative Pediatric and Adolescent Medicine, Gemeinschaftskrankenhaus Herdecke, Herdecke, Professorship for Integrative Pediatrics, Center for integrative medicine, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Holger N Lode
- Department of Pediatrics, Children's University Hospital, University of Greifswald, Greifswald, Germany
| | - Markus Metzler
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Hermann Müller
- Department of Pediatrics and Pediatric Hematology/Oncology, University Children's Hospital, Klinikum Oldenburg AöR, Carl von Ossietzky University, Oldenburg, Germany
| | - Dirk Reinhardt
- Pediatric Hematology and Oncology, University of Duisburg-Essen, Essen, Germany
| | - Axel Sauerbrey
- Clinic for Children and Adolescent Medicine, Helios Klinikum Erfurt, Erfurt, Germany
| | - Florian Schepper
- Department of Pediatric Oncology, Hematology and Hemostaseology, Leipzig University, Leipzig, Germany
| | | | - Dominik Schneider
- Clinic for Children and Adolescent Medicine, Klinikum Dortmund, Dortmund, Germany
| | | | - Matthias Richter
- Institute of Medical Sociology (IMS), Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany
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Holzer LA, Huyer N, Friesenbichler J, Leithner A. Body image, self-esteem, and quality of life in patients with primary malignant bone tumors. Arch Orthop Trauma Surg 2020; 140:1-10. [PMID: 31127406 PMCID: PMC6942008 DOI: 10.1007/s00402-019-03205-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patients with primary malignant bone tumors are facing different challenges in their everyday lives due to improved treatment and prolonged survival. This raises the question whether and to what extent their quality of life, body image, and self-esteem is affected by their disease. The aim of this retrospective study was to analyze the quality of life, body image and self-esteem of patients with primary malignant bone tumors compared to a healthy control group. METHODS A total of 56 patients (39 male, 17 female; average age 33.8 [± 14.29] years) who were treated with either osteosarcoma or Ewing-Sarcoma at the authors' institution between Jan 1989 and May 2015 were included into the study (mean follow-up: 9.1 ± 6.6] years). The control group consisted of 58 (average age 24.4 [± 3.1] years, 31 male, 27 female) healthy medical students. Standardized questionnaires were used to assess quality of life (SF-36), body image (MBSRQ) and self-esteem (RSE-scale). Student's t test were used for statistical analysis. RESULTS Quality of life (SF-36) (in physical categories) and body image (MBSRQ) was significantly lower in patients with primary malignant bone tumors compared to healthy cohort (p < 0.001). Self-esteem was not affected i n patients and did not show any difference compared to control group (23.96 vs. 24.00). DISCUSSION Physical categories of quality of life and body image sensation of patients with primary malignant bone tumors are worse compared healthy controls. However, self-esteem does not seem to be affected by the condition and its management. Patients can be encouraged about this at the time of diagnosis of a primary malignant bone tumor.
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Affiliation(s)
- Lukas A. Holzer
- grid.11598.340000 0000 8988 2476Department of Orthopaedics and Trauma, Medical University Graz, Auenbruggerplatz 5, 8036 Graz, Austria ,AUVA Trauma Center Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Nicolas Huyer
- grid.11598.340000 0000 8988 2476Department of Orthopaedics and Trauma, Medical University Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Jörg Friesenbichler
- grid.11598.340000 0000 8988 2476Department of Orthopaedics and Trauma, Medical University Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Andreas Leithner
- grid.11598.340000 0000 8988 2476Department of Orthopaedics and Trauma, Medical University Graz, Auenbruggerplatz 5, 8036 Graz, Austria
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Calaminus G, Jenney M, Hjorth L, Baust K, Bernstein M, Bielack S, Vos PD, Hogendoorn PCW, Jovic G, Krailo M, Kreitz K, Marina N, Popoola BO, Sauerland C, Smeland S, Teske C, Schweinitz CV, Whelan J, Wiener A, Sydes MR, Nagarajan R. Quality of Life of Patients With Osteosarcoma in the European American Osteosarcoma Study-1 (EURAMOS-1): Development and Implementation of a Questionnaire Substudy. JMIR Res Protoc 2019; 8:e14406. [PMID: 31573951 PMCID: PMC6819132 DOI: 10.2196/14406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/19/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The quality of life (QoL) of patients with osteosarcoma (OS) may be adversely affected by the disease or its treatment. Therefore, it is important to understand the QoL of patients undergoing treatment for OS to improve the QoL. We report on the first prospective international QoL study that was embedded within a large randomized clinical trial from 4 national study groups. OBJECTIVE This paper aimed to describe the QoL study development, methodology, accrual details, and characteristics of the QoL cohort. METHODS A total of 2260 patients registered in the EURopean AMerican Osteosarcoma Study-1 (EURAMOS-1), of whom 97.92% (2213/2260) were eligible for the optional QoL assessment and could participate in terms of questionnaire availability. Overall, 61.86% (1369/2213) of patients and/or proxies completed the QoL evaluation at the first assessment time point (E1) after the start of preoperative treatment. The QoL measures used (self- and/or proxy reports) depending on the patient's age and national study group. Participants and nonparticipants in the ancillary QoL study were compared regarding relevant demographic and disease-related characteristics at registration in the trial. RESULTS The participation rate at time point E1 did not differ with regard to age, gender, the occurrence of pathological fracture, or the presence of any metastases at diagnosis. No differences were found regarding the primary tumor site. Only the national study group affiliation had an influence on participation. Participation decreased linearly with trial progress up to 20% at the final time point of QoL assessment. CONCLUSIONS This study demonstrates the feasibility of international cooperation for the purpose of assessing and understanding the QoL of pediatric and adolescent/young adult patients with cancer. Future outcomes of this QoL substudy will help to adapt interventions to improve QoL.
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Affiliation(s)
- Gabriele Calaminus
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - Meriel Jenney
- Children & Women's Services Clinical Board, University Hospital of Wales, Cardiff, United Kingdom
| | - Lars Hjorth
- Pediatrics, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden
| | - Katja Baust
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - Mark Bernstein
- IWK Health Centre, Dalhousie University, Halifax, NS, Canada
| | - Stefan Bielack
- Cooperative Osteosarcoma Study Group, Klinikum Stuttgart - Olgahospital, Stuttgart, Germany
| | - Patricia De Vos
- Department of Pediatric Hematology and Oncology, Gent University Hospital, Gent, Belgium
| | | | - Gordana Jovic
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom
| | - Mark Krailo
- Department of Preventive Medicine, Keck Medical Center at the University of Southern California, Los Angeles, CA, United States.,Children's Oncolgy Group, Arcadia, CA, United States
| | - Kiana Kreitz
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Neyssa Marina
- Five Prime Therapeutics Inc, South San Francisco, CA, United States
| | - Babasola O Popoola
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom
| | - Cristina Sauerland
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Sigbjørn Smeland
- Division of Cancer Medicine and Scandinavian Sarcoma Group, Oslo University Hospital, Oslo, Norway.,Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carmen Teske
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - Clara V Schweinitz
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - Jeremy Whelan
- Department of Oncology, University College Hospital, London, United Kingdom
| | | | - Matthew R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom
| | - Rajaram Nagarajan
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Division of Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
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9
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Bult MK, van Bindsbergen KLA, Schepers SA, de Ridder-Sluiter HG, Verhaak CM, van Litsenburg RRL, Merks JHM, van Noesel MM, Grootenhuis MA. Health-Related Quality of Life of Adolescents with Cancer During the First Year of Treatment. J Adolesc Young Adult Oncol 2019; 8:616-622. [PMID: 31268387 DOI: 10.1089/jayao.2019.0017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Purpose: Adolescents with cancer (aged 12-18 years) are at risk for impaired health-related quality of life (HRQoL). Little is known about this population during treatment. This study aimed to (1) determine the HRQoL of adolescents with cancer during the first year of treatment and compare them with age-matched peers and (2) obtain insight into cancer-specific HRQoL of adolescents during the first year of treatment. Methods: Participants were part of a larger study focused on routine monitoring of electronic reported outcomes in standard pediatric oncology care. Adolescents completed the pediatric quality of life inventory (PedsQL) 4.0 and the PedsQL Cancer Module 3.0. Mean generic HRQoL scale scores were compared between the groups using multivariate analysis of covariance. Cancer-specific item scores were dichotomized and percentages were calculated to determine the proportion of adolescents reporting presence or absence of problems. Results: A total of 73 (mean [M]age = 14.71, standard deviation [SD] = 1.85) adolescents with cancer (Mage = 14.71, SD = 1.85, Mtimesincediagnosis = 3.51 months, SD = 2.8) and 268 healthy peers (Mage = 14.23, SD = 1.51) participated. Adolescents with cancer reported significantly lower generic HRQoL scores on all domains than their peers (p's <0.05, η2 = 0.01-0.42). Most frequently reported cancer-specific HRQoL problems were pain (hurt joint/muscle, 42.9%), nausea (during medical treatments [47.1%]; food not tasting good [54.3%]; food and smells [61.4%]), worry (about relapse [45.7%]; about side effects [52.9%]), cognitive problems (paying attention [47.1%]), and physical appearance (not good looking [47.1%]). Conclusions: Adolescents with cancer showed impaired HRQoL during treatment on both physical and psychosocial domains. Close monitoring of physical and psychosocial symptoms during treatment is, therefore, important.
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Affiliation(s)
- Maureen K Bult
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Sasja A Schepers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands
| | | | - Chris M Verhaak
- Amalia Children's Hospital/Radboud University Medical Center, Nijmegen, The Netherlands
| | - Raphaële R L van Litsenburg
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Johannes H M Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Max M van Noesel
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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10
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Zucchetti G, Bellini S, Bertolotti M, Bona F, Biasin E, Bertorello N, Tirtei E, Fagioli F. Body Image Discomfort of Adolescent and Young Adult Hematologic Cancer Survivors. J Adolesc Young Adult Oncol 2017; 6:377-380. [DOI: 10.1089/jayao.2016.0067] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Giulia Zucchetti
- Psycho-Oncology Service, Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O. Città della Salute e della Scienza—Ospedale Infantile “Regina Margherita,” Turin, Italy
| | - Simona Bellini
- Psycho-Oncology Service, Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O. Città della Salute e della Scienza—Ospedale Infantile “Regina Margherita,” Turin, Italy
| | - Marina Bertolotti
- Psycho-Oncology Service, Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O. Città della Salute e della Scienza—Ospedale Infantile “Regina Margherita,” Turin, Italy
| | - Francesca Bona
- Psycho-Oncology Service, Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O. Città della Salute e della Scienza—Ospedale Infantile “Regina Margherita,” Turin, Italy
| | - Eleonora Biasin
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O. Città della Salute e della Scienza—Ospedale Infantile “Regina Margherita,” Turin, Italy
| | - Nicoletta Bertorello
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O. Città della Salute e della Scienza—Ospedale Infantile “Regina Margherita,” Turin, Italy
| | - Elisa Tirtei
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O. Città della Salute e della Scienza—Ospedale Infantile “Regina Margherita,” Turin, Italy
| | - Franca Fagioli
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O. Città della Salute e della Scienza—Ospedale Infantile “Regina Margherita,” Turin, Italy
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11
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Belastungen und Reha-Ziele von Familien in der pädiatrisch-onkologischen Rehabilitation. Prax Kinderpsychol Kinderpsychiatr 2017; 66:194-208. [DOI: 10.13109/prkk.2017.66.3.194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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12
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Vlachioti E, Perdikaris P, Megapanou E, Sava F, Matziou V. Assessment of quality of life in adolescent patients with cancer and adolescent survivors of childhood cancer. J SPEC PEDIATR NURS 2016; 21:178-188. [PMID: 27554139 DOI: 10.1111/jspn.12154] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/10/2016] [Accepted: 07/07/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of the study was to assess the quality of life (QoL) of adolescents with cancer and survivors of childhood cancer as well as the effect of various demographic factors upon it. DESIGN AND METHODS The sample of the study included 82 adolescents aged 13-20 years who had been diagnosed with any type of cancer. Twenty-six of them received treatment and 56 survivors of childhood cancer had successfully completed their treatment. Data collection lasted from July 2010 to December 2012 in Children's Hematology-Oncology Unit in Athens. For data collection, Minneapolis-Manchester Quality Questionnaire of Life Instrument was used. The assessment of the QoL of adolescents undergoing treatment was performed with three measurements and that of the survivors with one. RESULTS The QoL of adolescent patients did not significantly change during treatment and they showed a satisfactory QoL. Boys scored higher than girls (z = -1.78, p = .04 in psychological function and t = 2.27, p = .02 in body image) as far as QoL in social relations is concerned (z = -2.79, p = .002 in first measurement and z = -2.31, p = .01 in second measurement). Scores on the scale for the QoL of survivors of childhood cancer who completed treatment was 3.91. Survivors showed a higher QoL than the adolescent patients. CONCLUSIONS This research has shown that the studied population scored a sufficient QoL, especially survivors of childhood cancer ones. Moreover, their QoL seemed to be influenced by the stage of treatment, the type of cancer, sex, age, family support, and their level of education.
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Affiliation(s)
- Efrosini Vlachioti
- Service Nursing Education Department, "Agia Sophia" Children's Hospital, Athens, Greece
| | - Pantelis Perdikaris
- Head Nurse, Pediatric Oncology Department, General Children's Hospital "P & A Kyriakou," Lecturer (407/80), Department of Nursing, University of Peloponnese, Athens, Greece.
| | | | - Floria Sava
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki Matziou
- Professor of Paediatric Nursing, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
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13
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Leiser D, Calaminus G, Malyapa R, Bojaxhiu B, Albertini F, Kliebsch U, Mikroutsikos L, Morach P, Bolsi A, Walser M, Timmermann B, Lomax T, Schneider R, Weber DC. Tumour control and Quality of Life in children with rhabdomyosarcoma treated with pencil beam scanning proton therapy. Radiother Oncol 2016; 120:163-8. [PMID: 27247053 DOI: 10.1016/j.radonc.2016.05.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/11/2016] [Accepted: 05/16/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE To assess clinical outcomes in children with rhabdomyosarcoma (RMS) treated with pencil beam scanning (PBS) proton therapy (PT). METHODS AND MATERIALS Eighty-three RMS (embryonal, n=74; 89%) patients treated between January 2000 and December 2014 were included. The median age was 4.5years (range, 0.8-15.5). All patients received systemic chemotherapy according to prospective protocols. Patients had low-, intermediate-, and high-risk disease in 24%, 63%, and 13% of cases, respectively. The median total dose delivered was 54Gy(RBE) (range, 41.4-64.8). RESULTS After a median follow-up time of 55.5 months (range, 0.9-126.3), local failure occurred in 16 patients. The 5-year local-control survival rate was 78.5% [95% confidence interval (CI), 69.5-88.5%]. Significant predictors for local failure were group/stage, tumour location, and size. Fourteen patients (16%) died, all from tumour progression. The 5-year overall survival was 80.6% (95%CI, 71.8-90.0%). The 5-year incidence of grade 3 non-ocular late toxicity was 3.6% (95%CI, 1-12%). No grade 4-5 late toxicities were observed. One radiation-induced malignancy was observed (1.2%). The Quality of Life (QoL) scores increased significantly after PT compared to baseline values. CONCLUSIONS PBS PT led to excellent outcome in children with RMS. Late non-ocular toxicity was minimal and QoL good.
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Affiliation(s)
- Dominic Leiser
- Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Switzerland; Center for Proton Therapy, Paul Scherrer Institute, Switzerland
| | - Gabriele Calaminus
- Department of Pediatric Hematology and Oncology, University Hospital Münster, Germany
| | - Robert Malyapa
- Center for Proton Therapy, Paul Scherrer Institute, Switzerland
| | - Beat Bojaxhiu
- Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Switzerland; Center for Proton Therapy, Paul Scherrer Institute, Switzerland
| | | | - Ulrike Kliebsch
- Center for Proton Therapy, Paul Scherrer Institute, Switzerland
| | | | - Petra Morach
- Center for Proton Therapy, Paul Scherrer Institute, Switzerland
| | | | - Marc Walser
- Center for Proton Therapy, Paul Scherrer Institute, Switzerland
| | - Beate Timmermann
- Clinic for Particle Therapy, University Hospital Essen, West German Proton Therapy Center Essen (WPE), Germany
| | - Tony Lomax
- Department of Pediatric Hematology and Oncology, University Hospital Münster, Germany; ETH Zürich, Switzerland
| | - Ralf Schneider
- Center for Proton Therapy, Paul Scherrer Institute, Switzerland
| | - Damien C Weber
- Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Switzerland; Center for Proton Therapy, Paul Scherrer Institute, Switzerland; University of Bern, Switzerland; University of Zürich, Switzerland.
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14
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Tallen G, Resch A, Calaminus G, Wiener A, Leiss U, Pletschko T, Friedrich C, Langer T, Grabow D, Driever PH, Kortmann RD, Timmermann B, Pietsch T, Warmuth-Metz M, Bison B, Thomale UW, Krauss J, Mynarek M, von Hoff K, Ottensmeier H, Frühwald M, Kramm CM, Temming P, Müller HL, Witt O, Kordes U, Fleischhack G, Gnekow A, Rutkowski S. Strategies to improve the quality of survival for childhood brain tumour survivors. Eur J Paediatr Neurol 2015; 19:619-39. [PMID: 26278499 DOI: 10.1016/j.ejpn.2015.07.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 07/05/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Tumours of the central nervous system (CNS) are the most frequent solid tumours and the second most frequent type of cancer in children and adolescents. Overall survival has continuously improved in Germany, since an increasing number of patients have been treated according to standardised, multicentre, multimodal treatment recommendations, trials of the German Paediatric Brain Tumour Consortium (HIT-Network) or the International Society of Paediatric Oncology-Europe (SIOP-E) during the last decades. Today, two out of three patients survive. At least 8000 long-term childhood brain tumour survivors (CBTS) are currently living in Germany. They face lifelong disease- and treatment-related late effects (LE) and associated socioeconomic problems more than many other childhood cancer survivors (CCS). METHOD We review the LE and resulting special needs of this particular group of CCS. RESULTS Despite their increasing relevance for future treatment optimisation, neither the diversity of chronic and cumulative LE nor their pertinent risk factors and subsequent impact on quality of survival have yet been comprehensively addressed for CBTS treated according to HIT- or SIOP-E-protocols. Evidence-based information to empower survivors and stakeholders, as well as medical expertise to manage their individual health care, psychosocial and educational/vocational needs must still be generated and established. CONCLUSION The establishment of a long-term research- and care network in Germany shall contribute to a European platform, that aims at optimising CBTSs' transition into adulthood as resilient individuals with high quality of survival including optimal levels of activity, participation and acceptance by society.
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Affiliation(s)
- Gesche Tallen
- Department of Paediatric Oncology/Haematology, Charité-Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin, Germany; Department of Paediatrics, Faculty of Medicine, University of Calgary, 2888 Shaganappi Trail N.W., Calgary, Alberta T3B 6A8, Canada.
| | - Anika Resch
- Department of Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany.
| | - Gabriele Calaminus
- Department of Paediatric Haematology and Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany.
| | - Andreas Wiener
- Department of Paediatric Haematology and Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany.
| | - Ulrike Leiss
- Medical University Vienna, Department of Paediatric and Adolescent Medicine, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Thomas Pletschko
- Medical University Vienna, Department of Paediatric and Adolescent Medicine, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Carsten Friedrich
- Department of Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany; Division of Paediatric Oncology, Haematology and Haemostaseology, Department of Woman's and Children's Health, University Hospital Leipzig, Liebigstr. 20a, 04103 Leipzig, Germany.
| | - Thorsten Langer
- Department of Paediatric Oncology/Haematology, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
| | - Desiree Grabow
- German Childhood Cancer Registry (GCCR), Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center, University of Mainz, Gebäude 902, Obere Zahlbacher Straße 69, 55131 Mainz, Germany.
| | - Pablo Hernáiz Driever
- Department of Paediatric Oncology/Haematology, Charité-Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Rolf-Dieter Kortmann
- Department of Radiation Oncology, University of Leipzig, Stephanstr. 9a, 04103 Leipzig, Germany.
| | - Beate Timmermann
- Particle Therapy Clinic at West German Proton Therapy Centre Essen, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.
| | - Torsten Pietsch
- Institute of Neuropathology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany.
| | - Monika Warmuth-Metz
- Dept. of Neuroradiology, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany.
| | - Brigitte Bison
- Dept. of Neuroradiology, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany.
| | - Ulrich-Wilhelm Thomale
- Department of Paediatric Neurosurgery, Charité-Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Jürgen Krauss
- Department of Neurosurgery, Head Clinic, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany.
| | - Martin Mynarek
- Department of Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany.
| | - Katja von Hoff
- Department of Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany.
| | - Holger Ottensmeier
- University Children's Hospital Würzburg, Dept. of Paed. Haematology, Oncology, Josef-Schneider-Str. 2, 97080 Würzburg, Germany.
| | - Michael Frühwald
- Department of Paediatric Oncology/Haematology, Klinikum Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Christof M Kramm
- Division of Paediatric Haematology and Oncology, University of Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.
| | - Petra Temming
- Paediatric Haematology/Oncology, Paediatrics III, University of Essen, Hufelandstr. 55, 45147 Essen, Germany.
| | - Hermann L Müller
- Paediatric Oncology/Haematology, Klinikum Oldenburg, Medical Campus University Oldenburg, Rahel-Straus-Str. 10, 26133 Oldenburg, Germany.
| | - Olaf Witt
- German Cancer Research Centre (DKFZ) and Department of Paediatric Oncology/Haematology, University of Heidelberg, Heidelberg, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Uwe Kordes
- Department of Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany.
| | - Gudrun Fleischhack
- Paediatric Haematology/Oncology, Paediatrics III, University of Essen, Hufelandstr. 55, 45147 Essen, Germany.
| | - Astrid Gnekow
- Department of Paediatric Oncology/Haematology, Klinikum Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Stefan Rutkowski
- Department of Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany.
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Lehmann V, Hagedoorn M, Gerhardt CA, Fults M, Olshefski RS, Sanderman R, Tuinman MA. Body issues, sexual satisfaction, and relationship status satisfaction in long-term childhood cancer survivors and healthy controls. Psychooncology 2015; 25:210-6. [PMID: 25959111 DOI: 10.1002/pon.3841] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 02/27/2015] [Accepted: 04/14/2015] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Research on body image and sexual satisfaction after adult onset cancer has shown significant and lasting impairments regarding survivors' sexuality and romantic relationships. However, knowledge about these topics and their associations in adult survivors of childhood cancer is largely lacking. METHODS Participants completed web-based questionnaires concerning body image, body dissociation, sexual satisfaction, and relationship status satisfaction (i.e., satisfaction with either being in a relationship or being single). Survivors (n = 87) and controls (n = 87) were matched on age and gender, with a mean age of 27 years (range: 20-40). Survivors were most often diagnosed with leukemia (46%), at an average of 16 years prior to study participation (range: 6-33 years). RESULTS Similar numbers of survivors and controls were single (n = 24/31), in a committed relationship (n = 33/23), or married (n = 30/33). Survivors and controls reported comparable levels of body image, body dissociation, sexual experiences, and sexual and status satisfaction (d = 0.15-0.28). Higher status satisfaction was associated with being in a relationship (compared with being single, β = 0.439), more positive body image (β = 0.196), and higher sexual satisfaction (β = 0.200). CONCLUSIONS Adult survivors of childhood cancer were comparable to healthy peers regarding views of their bodies and psychosexual development, which was unexpected. Independent of whether people experienced cancer or not, their status satisfaction was associated with their relationship status, body image, and sexual satisfaction. Future research should explore why sexual and body problems are identified after adult onset cancer, whereas this seems to be less of a problem in childhood cancer survivors.
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Affiliation(s)
- Vicky Lehmann
- The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Health Psychology Research Section, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Mariët Hagedoorn
- Health Psychology Research Section, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Cynthia A Gerhardt
- The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA
| | - Marci Fults
- The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Randal S Olshefski
- The Ohio State University, Columbus, OH, USA.,Nationwide Children's Hospital, Columbus, OH, USA
| | - Robbert Sanderman
- Health Psychology Research Section, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Marrit A Tuinman
- Health Psychology Research Section, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
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16
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Body image in cancer survivors: a systematic review of case-control studies. J Cancer Surviv 2014; 9:339-48. [DOI: 10.1007/s11764-014-0414-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 11/13/2014] [Indexed: 10/24/2022]
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17
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Hörnquist L, Rickardsson J, Lannering B, Gustafsson G, Boman KK. Altered self-perception in adult survivors treated for a CNS tumor in childhood or adolescence: population-based outcomes compared with the general population. Neuro Oncol 2014; 17:733-40. [PMID: 25332406 DOI: 10.1093/neuonc/nou289] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 08/28/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Survivors of pediatric CNS tumors are at risk for persistent tumor/treatment-related morbidity, physical disability and social consequences that may alter self-perception, vital for self-identity, mental health and quality of survival. We studied the long-term impact of childhood CNS tumors and their treatment on the self-perception of adult survivors and compared outcomes with those of the general population. METHODS The cohort included 697 Swedish survivors diagnosed with a primary CNS tumor during 1982-2001. Comparison data were randomly collected from a stratified general population sample. Survivors and general population individuals were compared as regards self-perception in 5 domains: body image, sports/physical activities, peers, work, and family, and with a global self-esteem index. Within the survivor group, determinants of impact on self-perception were identified. RESULTS The final analyzed sample included 528 survivors, 75.8% of the entire national cohort. The control sample consisted of 995, 41% of 2500 addressed. Survivors had significantly poorer self-perception outcomes in domains of peers, work, body image, and sports/physical activities, and in the global self-perception measure, compared with those of the general population (all P < .001). Within the survivor group, female gender and persistent visible physical sequelae predicted poorer outcomes in several of the studied domains. Tumor type and a history of cranial radiation therapy were associated with outcomes. CONCLUSION An altered self-perception is a potential late effect in adult survivors of pediatric CNS tumors. Self-perception and self-esteem are significant elements of identity, mental health and quality of survival. Therefore, care and psychosocial follow-up of survivors should include measures for identifying disturbances and for assessing the need for psychosocial intervention.
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Affiliation(s)
- Lina Hörnquist
- Childhood Cancer Research Unit, Karolinska Institutet, Astrid Lindgren Children's Hospital Q6:05, Stockholm, Sweden (L.H., J.R., G.G., K.K.B.); Department of Psychology, Stockholm University, Stockholm, Sweden (J.R.); Department of Clinical Sciences, Department of Pediatrics, The Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg, Sweden (B.L.)
| | - Jenny Rickardsson
- Childhood Cancer Research Unit, Karolinska Institutet, Astrid Lindgren Children's Hospital Q6:05, Stockholm, Sweden (L.H., J.R., G.G., K.K.B.); Department of Psychology, Stockholm University, Stockholm, Sweden (J.R.); Department of Clinical Sciences, Department of Pediatrics, The Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg, Sweden (B.L.)
| | - Birgitta Lannering
- Childhood Cancer Research Unit, Karolinska Institutet, Astrid Lindgren Children's Hospital Q6:05, Stockholm, Sweden (L.H., J.R., G.G., K.K.B.); Department of Psychology, Stockholm University, Stockholm, Sweden (J.R.); Department of Clinical Sciences, Department of Pediatrics, The Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg, Sweden (B.L.)
| | - Göran Gustafsson
- Childhood Cancer Research Unit, Karolinska Institutet, Astrid Lindgren Children's Hospital Q6:05, Stockholm, Sweden (L.H., J.R., G.G., K.K.B.); Department of Psychology, Stockholm University, Stockholm, Sweden (J.R.); Department of Clinical Sciences, Department of Pediatrics, The Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg, Sweden (B.L.)
| | - Krister K Boman
- Childhood Cancer Research Unit, Karolinska Institutet, Astrid Lindgren Children's Hospital Q6:05, Stockholm, Sweden (L.H., J.R., G.G., K.K.B.); Department of Psychology, Stockholm University, Stockholm, Sweden (J.R.); Department of Clinical Sciences, Department of Pediatrics, The Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg, Sweden (B.L.)
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18
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Özyurt J, Thiel CM, Lorenzen A, Gebhardt U, Calaminus G, Warmuth-Metz M, Müller HL. Neuropsychological outcome in patients with childhood craniopharyngioma and hypothalamic involvement. J Pediatr 2014; 164:876-881.e4. [PMID: 24507865 DOI: 10.1016/j.jpeds.2013.12.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 11/01/2013] [Accepted: 12/05/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To test memory performance and executive functions in patients with childhood craniopharyngioma and hypothalamic involvement. STUDY DESIGN Using standardized neuropsychological tests, we compared cognitive performance in a group of 15 patients with childhood craniopharyngioma and known hypothalamic involvement and a group of 24 age- and intelligence-matched control subjects. In addition, we compared individual patients' results with normative data to detect abnormal performance in the clinically relevant range. Within the patient group, we further tested whether the grade of hypothalamic involvement had an impact on cognitive performance and quality of life. RESULTS Relative to healthy controls, the patients demonstrated significantly lower performance scores in tests of memory and executive functioning. On the individual performance level, delayed recall performance was severely impaired in one-third of the patients. Compared with patients with low-grade hypothalamic involvement, those with high-grade hypothalamic involvement showed worse performance in executive functions and reduced functional capabilities for daily life actions, indicating lower quality of life. CONCLUSION Our findings demonstrate that hypothalamic involvement is related to impairments in memory and executive functioning in patients with childhood craniopharyngioma and indicate that a high grade of hypothalamic involvement is related to worse outcomes.
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Affiliation(s)
- Jale Özyurt
- Biological Psychology Laboratory, Department of Psychology, Carl von Ossietzky University, Oldenburg, Germany
| | - Christiane M Thiel
- Biological Psychology Laboratory, Department of Psychology, Carl von Ossietzky University, Oldenburg, Germany; Research Center for Neurosensory Science, Carl von Ossietzky University, Oldenburg, Germany
| | - Anna Lorenzen
- Biological Psychology Laboratory, Department of Psychology, Carl von Ossietzky University, Oldenburg, Germany; Center for Integrative Psychiatry, Department of Child and Adolescent Psychiatry and Psychotherapy, Christian Albrechts University School of Medicine, Kiel, Germany
| | - Ursel Gebhardt
- Department of Pediatrics and Pediatric Hematology and Oncology, Center for Child and Adolescent Medicine, Klinikum Oldenburg, Oldenburg, Germany
| | - Gabriele Calaminus
- Department of Pediatric Hematology and Oncology, Münster University Hospital, Münster, Germany
| | - Monika Warmuth-Metz
- Department of Neuroradiology, Würzburg University Hospital, Würzburg, Germany
| | - Hermann L Müller
- Department of Pediatrics and Pediatric Hematology and Oncology, Center for Child and Adolescent Medicine, Klinikum Oldenburg, Oldenburg, Germany
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Heart rate variability reflects the natural history of physiological development in healthy children and is not associated with quality of life. PLoS One 2014; 9:e91036. [PMID: 24625571 PMCID: PMC3953202 DOI: 10.1371/journal.pone.0091036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 02/10/2014] [Indexed: 01/13/2023] Open
Abstract
Background Quality of life (QoL), being the sum expression of diverse influencing factors, is not easy to determine. A clinically relevant option would be to identify and measure quality of life on the basis of physiological parameters which correlate plausibly and statistically with psychometrically measured QoL. Analysis of heart rate variability (HRV) offers readily measurable physiological parameters which could be of use here. A correlation of HRV with both course of disease and QoL has been reported in patients with chronic illness. Various psychometric instruments have been developed for use in paediatric oncology. The aim of this study was to obtain data on HRV and QoL and their correlations, initially in healthy children. Methods Holter ECG and quality of life were examined in 160 children and adolescents (72 male) aged between 8 and 18 years. QoL was determined with the established questionnaire PEDQoL. Standard parameters of HRV from the frequency domain were calculated and correlated with QoL domains using Spearman (nonparametric) correlation analysis. Results Minor but significant associations were revealed only with regard to the PEDQoL domain “autonomy” on the one hand and heart rate and HRV (e.g. MRR, MRRn, MRRd, HRV_ULF, SDNN) parameters which evidently reflect distinct physiological functions on the other. Conclusions In healthy children and adolescents we have a first indication that there is a correlation between parameters of HRV and QoL. However, to a greater extent, HRV reflects associated physiological processes of the autonomic nervous system. A higher correlation is more likely to be found in chronically ill children.
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Park HJ, Yang HK, Shin DW, Kim YY, Kim YA, Yun YH, Nam BH, Bhatia S, Park BK, Ghim TT, Kang HJ, Park KD, Shin HY, Ahn HS. Cross-cultural adaptation of the korean version of the minneapolis-manchester quality of life instrument-adolescent form. J Korean Med Sci 2013; 28:1788-95. [PMID: 24339710 PMCID: PMC3857376 DOI: 10.3346/jkms.2013.28.12.1788] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 10/08/2013] [Indexed: 11/25/2022] Open
Abstract
We verified the reliability and validity of the Korean version of the Minneapolis-Manchester Quality of Life Instrument-Adolescent Form (KMMQL-AF) among Korean childhood cancer survivors. A total of 107 childhood cancer patients undergoing cancer treatment and 98 childhood cancer survivors who completed cancer treatment were recruited. To assess the internal structure of the KMMQL-AF, we performed multi-trait scaling analyses and exploratory factor analysis. Additionally, we compared each domains of the KMMQL-AF with those of the Karnofsky Performance Status Scale and the Revised Children's Manifest Anxiety Scale (RCMAS). Internal consistency of the KMMQL-AF was sufficient (Cronbach's alpha: 0.78-0.92). In multi-trait scaling analyses, the KMMQL-AF showed sufficient construct validity. The "physical functioning" domain showed moderate correlation with Karnofsky scores and the "psychological functioning" domain showed moderate-to-high correlation with the RCMAS. The KMMQL-AF discriminated between subgroups of different adolescent cancer survivors depending on treatment completion. The KMMQL-AF is a sufficiently reliable and valid instrument for measuring quality of life among Korean childhood cancer survivors.
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Affiliation(s)
- Hyeon Jin Park
- Center for Pediatric Oncology, National Cancer Center, Goyang, Korea
| | - Hyung Kook Yang
- Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Dong Wook Shin
- Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, Korea
- Cancer Survivorship Clinic, Seoul National University Cancer Hospital, Seoul, Korea
| | - Yoon Yi Kim
- Korea Childhood Leukemia Foundation, Seoul, Korea
| | - Young Ae Kim
- Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Young Ho Yun
- Cancer Research Institute, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Byung Ho Nam
- Cancer Biostatistics Branch, National Cancer Research Institute, National Cancer Center, Goyang, Korea
| | - Smita Bhatia
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Byung Kiu Park
- Center for Pediatric Oncology, National Cancer Center, Goyang, Korea
| | - Thad T. Ghim
- Center for Pediatric Oncology, National Cancer Center, Goyang, Korea
| | - Hyoung Jin Kang
- Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Duk Park
- Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Young Shin
- Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hyo Seop Ahn
- Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Landier W, Leonard M, Ruccione KS. Children's Oncology Group's 2013 blueprint for research: nursing discipline. Pediatr Blood Cancer 2013; 60:1031-6. [PMID: 23255369 PMCID: PMC3645887 DOI: 10.1002/pbc.24415] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 11/05/2012] [Indexed: 01/14/2023]
Abstract
Integration of the nursing discipline within cooperative groups conducting pediatric oncology clinical trials provides unique opportunities to maximize nursing's contribution to clinical care, and to pursue research questions that extend beyond cure of disease to address important gaps in knowledge surrounding the illness experience. Key areas of importance to the advancement of the nursing discipline's scientific knowledge are understanding the effective delivery of patient/family education, and reducing illness-related distress, both of which are integral to facilitating parental/child coping with the diagnosis and treatment of childhood cancer, and to promoting resilience and well-being of pediatric oncology patients and their families.
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Affiliation(s)
- Wendy Landier
- Department of Population Sciences, City of Hope, Duarte, CA 91010, USA.
| | - Marcia Leonard
- Division of Pediatric Hematology/Oncology, C. S. Mott Children’s Hospital, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Kathleen S. Ruccione
- Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
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22
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Hinds PS, Nuss SL, Ruccione KS, Withycombe JS, Jacobs S, DeLuca H, Faulkner C, Liu Y, Cheng YI, Gross HE, Wang J, DeWalt DA. PROMIS pediatric measures in pediatric oncology: valid and clinically feasible indicators of patient-reported outcomes. Pediatr Blood Cancer 2013; 60:402-8. [PMID: 22829446 DOI: 10.1002/pbc.24233] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 05/22/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND Establishing the ability of children and adolescents with cancer to complete the NIH-sponsored PROMIS pediatric measures electronically and the preliminary validity estimates of the measures (both full item banks and short forms) in pediatric oncology will contribute to our knowledge of the impact of cancer treatment on these young patients. PROCEDURES A total of 203 8- to 17-year olds were administered eight PROMIS pediatric measures in a cross-sectional study design to establish known-group validity. Of the 200 who completed all or most of the items, a slight majority were male (55.5%) and white (54%). Patients were either undergoing treatment for cancer (n = 93) or in survivorship following treatment for cancer (n = 107). Measures were completed using computer interface during an in-person interaction with researchers. RESULTS Only 3 of 203 participants did not complete the PROMIS pediatric measures. As hypothesized, participants in treatment were significantly different (worse) on parent-reported clinical indicators (blood counts, fatigue, and appetite) and on seven self-reported measures (depression, anxiety, peer relationships, pain interference, fatigue, upper extremity function, and mobility) from participants in survivorship. Females reported worse fatigue, anger, and pain interference than males. Worse patient-reported outcomes for patients in active treatment persisted after adjusting for potential confounding variables. CONCLUSIONS Children and adolescents in treatment for cancer or in survivorship and ranging from 8 to 17 years of age can complete multiple PROMIS pediatric measures using a computer interface during an outpatient clinic visit or inpatient admission. Findings establish known-group validity for PROMIS pediatric measures in pediatric oncology.
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Affiliation(s)
- Pamela S Hinds
- Children's National Medical Center, Washington, District of Columbia, USA.
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Gianinazzi ME, Rueegg CS, Wengenroth L, Bergstraesser E, Rischewski J, Ammann RA, Kuehni CE, Michel G. Adolescent survivors of childhood cancer: are they vulnerable for psychological distress? Psychooncology 2013; 22:2051-8. [DOI: 10.1002/pon.3249] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 12/03/2012] [Accepted: 01/03/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Micol E. Gianinazzi
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine; University of Bern; Finkenhubelweg 11; 3012; Bern; Switzerland
| | - Corina S. Rueegg
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine; University of Bern; Finkenhubelweg 11; 3012; Bern; Switzerland
| | - Laura Wengenroth
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine; University of Bern; Finkenhubelweg 11; 3012; Bern; Switzerland
| | - Eva Bergstraesser
- Department of Oncology; University Children's Hospital; Steinwiesstrasse 75; 8032; Zurich; Switzerland
| | - Johannes Rischewski
- Department of Pediatric Oncology and Hematology; Children's Hospital; 6000; Lucerne; Switzerland
| | - Roland A. Ammann
- Department of Pediatrics; University of Bern, Inselspital; 3010; Bern; Switzerland
| | - Claudia E. Kuehni
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine; University of Bern; Finkenhubelweg 11; 3012; Bern; Switzerland
| | - Gisela Michel
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine; University of Bern; Finkenhubelweg 11; 3012; Bern; Switzerland
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Oh SM, Lee HJ, Kim GS, Park KD. Factors Affecting Social Adjustment of Childhood Cancer Survivors. CHILD HEALTH NURSING RESEARCH 2013. [DOI: 10.4094/chnr.2013.19.3.238] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Su-Mi Oh
- Pediatric Cancer Center, Seoul National University Hospital, Seoul, Korea
| | - Hye-Jung Lee
- The Nursing Policy Research Institute, College of Nursing, Yonsei University, Seoul, Korea
| | - Gwang-Suk Kim
- The Nursing Policy Research Institute, College of Nursing, Yonsei University, Seoul, Korea
| | - Kyung-Duk Park
- Pediatric Cancer Center, Seoul National University Hospital, Seoul, Korea
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[Survivors of pediatric cancer. Developmental paths and outcomes between trauma and resilience]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55:481-92. [PMID: 22441518 DOI: 10.1007/s00103-012-1449-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In Europe and North America, about 80% of all patients with cancer in childhood and adolescence survive their leukemia, lymphomas or tumors. Therefore, neuropsychological impairments, psychopathological comorbidity and health-related quality of life become relevant parameters for treatment evaluation and conceptualization of future therapy protocols. During the last decade, a number of patient registries, multicenter studies and meta-analyses have analyzed the interaction of disease- and treatment-associated risk factors with pre-existing socio-demographic and psychosocial vulnerability factors. Brain tumors and treatment strategies including CNS surgery, cranial radiotherapy and intrathecal chemotherapy carry an increased risk for neurological and neuropsychological long-term outcomes, which in turn also threatens the patients' psychosocial and vocational participation. In the area of psychosocial adaptation, a wide range of developmental paths results, ranging from increased psychological comorbidity, to subclinical impairments in quality of life, to normal courses to resilient outcomes, even with a developmental benefit. A hypothetical model is presented to explain this enormous variance in outcomes. Protective cognitive-emotional schemata already established at the premorbid stage predispose patients to be able to cope successfully with cancer-related challenges and thus further enhance the patients' future adaptability. In contrast, dysfunctional schemata at the premorbid level increase risks of coping failure and thus intensify the long-term risk for psychopathological comorbidity in terms of post-traumatic stress disorder, anxiety disorder or depression.
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Berg C, Hayashi RJ. Participation and Self-Management Strategies of Young Adult Childhood Cancer Survivors. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2012. [DOI: 10.3928/15394492-20120607-01] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
This study describes a connection between late effects, engagement in major life activities, and self-management strategies in young adult childhood cancer survivors. A mailed survey focused on late effects of pain, fatigue, depression, cognition, memory, and body image distortion and their impact on work, education, independent living, and community and social engagement. Additionally, survivors identified self-management strategies that minimize their late effects. Eighty-eight percent of the 42 responders struggled with at least one of the six late effects. Work and educational pursuits were affected, with memory and fatigue the most intrusive to daily activities. Self-management strategies of sleep/rest, fitness, quiet leisure, and support of family/friends were the most common. Reaching out to long-term follow-up cancer clinics, health professionals, survivors, or community resources were the least employed management strategies. Occupational therapists can look to community models for educating survivors about self-management, and take this opportunity to define new collaborative partnerships with long-term follow-up cancer clinics and community agencies to assist young adult survivors transitioning to adult roles.
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Die deutsche Kohorte Langzeitüberlebender nach Krebs im Kindesalter. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55:843-51. [DOI: 10.1007/s00103-012-1500-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bradley Eilertsen ME, Jozefiak T, Rannestad T, Indredavik MS, Vik T. Quality of life in children and adolescents surviving cancer. Eur J Oncol Nurs 2012; 16:185-93. [DOI: 10.1016/j.ejon.2011.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Revised: 08/15/2011] [Accepted: 08/18/2011] [Indexed: 01/15/2023]
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Wu WW, Johnson R, Schepp KG, Berry DL. Electronic self-report symptom and quality of life for adolescent patients with cancer: a feasibility study. Cancer Nurs 2012; 34:479-86. [PMID: 21372703 DOI: 10.1097/ncc.0b013e31820a5bdd] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Computerized symptom and quality of life (QoL) assessment has been tested and found feasible and acceptable in outpatient settings for adult patients with cancer, but has not been used often in pediatric oncology settings in the United States. OBJECTIVE The purpose of this pilot study was to evaluate the feasibility of an innovative, computerized symptom, and QoL assessment for adolescent patients who were being treated for cancer. METHODS A convenience sample of 40 adolescent patients with cancer, who were between 13 and 20 years old and able to communicate in English, agreed to participate. Each participant answered the Web-based Electronic Self-report Assessment-Cancer Adolescent Form on a wireless touch-screen computer just prior to a treatment visit in an ambulatory clinic setting. Descriptive frequencies and central tendency were used to describe sample characteristics and feasibility outcomes. RESULTS The computerized assessment was found to be feasible with regard to data completeness rates (>99%), acceptability (high), time to complete (30 minutes), and assistance required to complete (minimal). CONCLUSION The Electronic Self-report Assessment-Cancer Adolescent Form is a feasible approach for obtaining adolescent patients' self-report of cancer symptoms and QoL in an ambulatory setting. IMPLICATIONS FOR PRACTICE Screening for symptoms and QoL may be integrated during check-in procedures as routine assessment for adolescent cancer patients in ambulatory settings.
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Affiliation(s)
- Wei-Wen Wu
- Department of Nursing, National Taipei University of Nursing and Health Sciences School of Nursing, Taiwan
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30
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Oncologists’ view of informed consent and shared decision making in paediatric radiation oncology. Radiother Oncol 2012; 102:210-3. [DOI: 10.1016/j.radonc.2011.07.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 05/24/2011] [Accepted: 07/20/2011] [Indexed: 11/23/2022]
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Bölling T, Ernst I, Pape H, Martini C, Rübe C, Timmermann B, Fischedick K, Kortmann RD, Willich N. Dose–Volume Analysis of Radiation Nephropathy in Children: Preliminary Report of the Risk Consortium. Int J Radiat Oncol Biol Phys 2011; 80:840-4. [DOI: 10.1016/j.ijrobp.2010.03.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Revised: 02/28/2010] [Accepted: 03/09/2010] [Indexed: 10/19/2022]
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Reimers TS, Mortensen EL, Nysom K, Schmiegelow K. Health-related quality of life in long-term survivors of childhood brain tumors. Pediatr Blood Cancer 2009; 53:1086-91. [PMID: 19499581 DOI: 10.1002/pbc.22122] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND To identify predictors for health-related quality of life (HRQOL) in survivors of childhood brain tumors and its relationship to cognitive function. PROCEDURE One hundred twenty-six consecutive Danish childhood brain tumor patients treated 1970-1997 and being 7.9-40.4 years at follow-up were assessed for general intelligence (IQ) and administered the Minneapolis-Manchester Quality of Life (MMQL) questionnaire. RESULTS In multivariate linear regression treatment with RT was the most important risk factor for reduced HRQOL. Lower scores for physical functioning and energy, social functioning, cognitive functioning, body image, outlook of life, and intimate relations were significantly related to RT. Tumor location in the posterior fossa was associated with lower scores for physical functioning and energy, and tumor site in the third ventricle region was associated with lower scores for body image. Younger age at diagnosis was associated with lower scores for social functioning and intimate relations, and younger age at follow-up was associated with more physical symptoms. When IQ was included as a covariate, RT only remained significant for social functioning and intimate relations while tumor location in the third ventricle region remained significant for body image, younger age at diagnosis for social functioning and intimate relations, and younger age at follow-up for physical symptoms. In contrasts, neither gender nor presence of hydrocephalus requiring shunt inserted predicted significantly reduced HRQOL in the multivariate analyses. CONCLUSION RT is an important predictor of HRQOL primarily due to its effect on general intelligence, which suggests that IQ is a strong determinant of HRQOL.
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Affiliation(s)
- Tonny Solveig Reimers
- Department of Psychology, Play Therapy and Social Counselling, The Juliane Marie Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
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Fan SY, Eiser C. Body image of children and adolescents with cancer: A systematic review. Body Image 2009; 6:247-56. [PMID: 19632908 DOI: 10.1016/j.bodyim.2009.06.002] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 06/19/2009] [Accepted: 06/19/2009] [Indexed: 10/20/2022]
Abstract
We report a systematic literature review to identify (1) differences in body image (BI) between children and adolescents with cancer and healthy controls; (2) relationships between BI and demographic or medical variables; (3) implications of BI for psychological adjustment; and (4) relationship between BI and social support. Thirty-two studies were identified from computerized databases including BNI (1985-March, 2008), CINAHL (1982-March, 2008), MEDLINE (1950-March, 2008), PsychInfo (1806-March, 2008), and PubMed (1950-March, 2008). There was no consistent evidence regarding BI differences between children and adolescents with cancer and healthy controls. Relations between BI and gender, disease characteristics, and psychological adjustment were found. Changes in BI have adverse implications for self-esteem and adjustment, but can be moderated by social support. Future research should also adopt broader definitions of BI, and cancer-specific age-appropriate BI measures are needed to increase sensitivity of this work.
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Affiliation(s)
- Sheng-Yu Fan
- Department of Psychology, University of Sheffield, Western Bank, Sheffield S10 2TP, UK.
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Evaluation of Side Effects After Radiotherapy in Childhood and Adolescence: From Retrospective Case Reports to a Prospective, Multicentric and Transnational Approach. Strahlenther Onkol 2009; 185 Suppl 2:3-4. [DOI: 10.1007/s00066-009-1003-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Peeters J, Meitert J, Paulides M, Beck JD, Langer T. Late Effects Surveillance System After Childhood Cancer in Germany, Austria and Parts of Switzerland – Update 2009. Strahlenther Onkol 2009; 185 Suppl 2:5-7. [DOI: 10.1007/s00066-009-1004-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Health-related quality of life (HRQL) is concerned with the opportunities that a person's health status affords, the constraints that it places upon the person and the value that a person places on his or her health status. The rationale for measuring HRQL falls into three categories: discrimination, evaluation, and prediction. Measures have to meet generally accepted psychometric criteria such as acceptability, reliability/reproducibility, responsiveness, validity, interpretability, and usefulness. HRQL instruments have been designed for self-administration or administration by interviews and some have been adapted to multiple cultural/linguistic needs. For adolescents and young adults with cancer several instruments are available. Overall HRQL is compromised, to varying degrees, in such survivors by comparison with peers in the general population; and the burden of morbidity is greatest after brain and bone tumors. As there is a burden of treatment-related morbidity and as the number of survivors within the health care system is growing, the economic dimension of care and cure has to be taken into consideration. Economic evaluation affords a comparison of the costs and consequences (effects) of relevant therapeutic alternatives. The future research activities with respect to HRQL have to consider these new dimensions of care.
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Affiliation(s)
- Gabriele Calaminus
- Department of Pediatric Hematology-Oncology, University of Muenster, Muenster, Germany.
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