1
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Wilson CL, Bjornard KL, Partin RE, Kadan-Lottick NS, Nathan PC, Oeffinger KC, Hayashi RJ, Hyun G, Armstrong GT, Leisenring WM, Howell RM, Yasui Y, Dixon SB, Ehrhardt MJ, Robison LL, Ness KK. Trends in physical functioning in acute lymphoblastic leukemia and non-Hodgkin lymphoma survivors across three decades. J Cancer Surviv 2023:10.1007/s11764-023-01483-1. [PMID: 37938431 DOI: 10.1007/s11764-023-01483-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/09/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE The impact of changes in therapy for childhood acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL) on the prevalence of physical performance limitations and participation restrictions among survivors is unknown. We aimed to describe the prevalence of reduced function among ALL and NHL survivors by treatment era. METHODS Participants included survivors of childhood ALL and NHL, and a cohort of their siblings, participating in the Childhood Cancer Survivor Study (CCSS). Physical function was measured using questionnaire. The prevalence of reduced function was compared to siblings using generalized estimating equations, overall and stratified by treatment decade. Associations between organ system-specific chronic conditions (CTCAE v4.03) and function were also evaluated. RESULTS Among 6511 survivors (mean age 25.9 years (standard deviation 6.5)) and 4127 siblings, risk of performance limitations (15.2% vs. 12.5%, prevalence ratio [PR] = 1.5, 95%CI = 1.3-1.6), restrictions in personal care (2.0% vs. 0.6%, PR = 3.1, 95% CI = 2.0-4.8), routine activities (5.5% vs. 1.6%, PR = 3.6, 95% CI = 2.7-4.8), and work/school attendance (8.8% vs. 2.1%, PR = 4.5, 95% CI = 3.6-5.7) was increased in survivors vs. siblings. The prevalence of survivors reporting reduced function did not decrease between the 1970s and 1990s. The presence of neurological and cardiovascular conditions was associated with reduced function regardless of treatment decade. CONCLUSIONS Despite changes in therapy, the prevalence of poor physical function remained constant between the 1970s and 1990s. The CCSS clinical trial registration number is NCT01120353 (registered May 6, 2010). IMPLICATIONS FOR CANCER SURVIVORS Our findings support screening for reduced physical function so that early interventions to improve physical performance and mitigate chronic disease can be initiated.
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Affiliation(s)
- Carmen L Wilson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Kari L Bjornard
- Department of Hematology/Oncology, Riley Children's Hospital, Indianopolis, IN, USA
| | - Robyn E Partin
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Nina S Kadan-Lottick
- Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Paul C Nathan
- Division of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | - Robert J Hayashi
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Geehong Hyun
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Wendy M Leisenring
- Cancer Prevention and Clinical Statistics Program, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Rebecca M Howell
- Radiation Physics Department, The University of Texas at MD Anderson Cancer Center, Houston, TX, USA
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Stephanie B Dixon
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Matthew J Ehrhardt
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
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2
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Grydeland M, Bratteteig M, Rueegg CS, Lie HC, Thorsen L, Larsen EH, Brügmann-Pieper S, Torsvik IK, Götte M, Lähteenmäki PM, Kriemler S, Fridh MK, Anderssen SA, Ruud E. Physical Activity Among Adolescent Cancer Survivors: The PACCS Study. Pediatrics 2023; 152:e2023061778. [PMID: 37646086 DOI: 10.1542/peds.2023-061778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVES Physical activity (PA) may modify risks of late effects after cancer. We aimed to examine levels of PA and sedentary time (ST) in a large, international sample of adolescent childhood cancer survivors in relation to sociodemographic and cancer-related factors and compare levels of PA and ST to reference cohorts. METHODS Survivors from any cancer diagnosis who had completed cancer treatment ≥1 year ago, aged 9 to 16 years, were eligible for the multicenter Physical Activity in Childhood Cancer Survivors study. PA and ST were measured by ActiGraph GT3X+ accelerometers. We performed linear regression analyses to assess factors associated with moderate-to-vigorous PA (MVPA) and ST, and compared marginal means of total PA, MVPA, and ST in 432 survivors to sex- and age-stratified references (2-year intervals) using immediate t-tests for aggregated data. RESULTS Among survivors, 34% fulfilled the World Health Organization's PA recommendation of ≥60 min of daily MVPA on average and their ST was 8.7 hours per day. Being female, older, overweight, a survivor of central nervous system tumor, or having experienced relapse were associated with lower MVPA and/or higher ST. Generally, male survivors spent less time in MVPA compared with references, whereas female survivors had similar levels. Both male and female survivors had higher ST than references in nearly all age groups. CONCLUSIONS The low PA and high ST in this large sample of adolescent childhood cancer survivors is worrisome. Combined, our results call for targeted interventions addressing both PA and ST in follow-up care after childhood cancer.
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Affiliation(s)
| | - Mari Bratteteig
- Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Hanne C Lie
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Division of Cancer Medicine
- Division of Cancer Medicine, Department of Clinical Service
| | - Elna H Larsen
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine
| | - Sabine Brügmann-Pieper
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid K Torsvik
- Department of Pediatrics and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
| | - Miriam Götte
- West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Päivi M Lähteenmäki
- Department of Pediatric and Adolescent Hematology and Oncology, Turku University Hospital, FICAN-West, University of Turku, Turku, Finland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Martin K Fridh
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | - Ellen Ruud
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, University of Oslo, Oslo, Norway
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3
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Keating R, Curry S, Hussey J. Cardiorespiratory fitness and health-related quality of life in survivors of childhood central nervous system tumours. Support Care Cancer 2023; 31:395. [PMID: 37318588 DOI: 10.1007/s00520-023-07854-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE We assessed cardiorespiratory fitness and health-related quality of life (HRQoL) in survivors of childhood central nervous system (CNS) tumours. METHODS Participants were recruited from the National Children's Cancer Service in Children's Health Ireland at Crumlin. Inclusion criteria included diagnosis of a primary CNS tumour, aged between 6 and 17 years, between 3 months and 5 years post completion of oncology treatment, independently mobile, and deemed clinically appropriate to participate by treating oncologist. Cardiorespiratory fitness was assessed using the six-minute walk test. HRQoL was assessed with the PedsQL Generic Core Scales, Version 4.0. RESULTS Thirty-four participants (n = 16 male) were recruited, with a mean age of 12.21 ± 3.31 years and a mean time since completion of oncology treatment of 2.19 ± 1.29 years. Mean six-minute walk distance (6MWD) achieved was 489.56 ± 61.48 m, equating to the 8th percentile overall. 6MWD was significantly reduced when compared to predicted population norms (p < 0.001). PedsQL parent proxy-report and child-report scores were significantly lower when compared to healthy paediatric norms (p < 0.001 - p = 0.011). A significant positive correlation was found between 6MWD and both parent proxy-report (r = 0.55, p < 0.001) and child-report (r = 0.48, p = 0.005) PedsQL total scores. CONCLUSION Survivors of childhood CNS tumours present with impaired cardiorespiratory fitness and HRQoL. Higher levels of cardiorespiratory fitness are associated with higher levels of HRQoL. IMPLICATIONS FOR CANCER SURVIVORS Routine screening of cardiorespiratory fitness and HRQoL in survivors of childhood CNS tumours may be beneficial. Healthcare providers should encourage and provide education on the potential benefits of physical activity to improve overall quality of life.
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Affiliation(s)
- Rachael Keating
- School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland.
- Physiotherapy Department, Children's Health Ireland at Crumlin, Dublin, Ireland.
| | - Sarah Curry
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Juliette Hussey
- School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland
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4
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Hoffmann-Lamplmair D, Gram A, Krottendorfer K, Peyrl A, Leiss U, Czech T, Slavc I, Pletschko T. Sociocultural variables have a major impact on participation in patients treated for paediatric posterior fossa tumours. Child Care Health Dev 2023; 49:106-118. [PMID: 35708465 PMCID: PMC10083959 DOI: 10.1111/cch.13023] [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: 09/24/2021] [Revised: 03/21/2022] [Accepted: 06/13/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study investigates the severeness of participation barriers in patients surviving paediatric posterior fossa tumours (PFT) many years after treatment. In the past, aetiological studies on adverse outcome have primarily focused on pathobiological risk factors. The current analysis aims to investigate the importance of environmental variables. METHODS On average, 10 years after diagnosis, educational and social difficulties of 42 patients surviving paediatric PFT (mean age 17 years) were inquired using a self-constructed questionnaire following the Psychosocial Resource-Orientated Assessment (PREDI). Educational or social participation barriers were defined by self- and/or proxy-reported difficulties in school or in peer relationships. Accordingly, the children and adolescents were categorized into groups of adequate and limited participation. Subsequently, the study identified potential pathobiological (treatment type, hydrocephalus, tumour relapse, gender, age at diagnosis, seizures and cerebellar mutism) and environmental (parental and maternal education, siblings, main language, discrepancies between personal and environmental values, regular physical activity and private living space) risk factors and investigated whether patients with adequate and limited participation differed in the number of risk factors. RESULTS Almost one decade after treatment, two thirds of patients experienced educational and/or social difficulties. Patients with limited participation were more frequently associated with environmental factors such as low maternal education degree, siblings, main language other than German, discrepancies between societal and personal values and irregular physical activity, as well as the pathobiological risk factors treatment type, hydrocephalus, tumour relapse, cerebellar mutism and seizures. These variables significantly discriminated between patients with and without limited participation. CONCLUSIONS Limited participation in patients treated for paediatric PFT is common. Next to pathobiological, also environmental risk factors play a major role in educational and social participation barriers. This highlights the fact that solely considering pathobiology is not sufficient when investigating risk factors for the emergence of late sequelae. Future aetiological studies must adopt a biopsychosocial perspective.
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Affiliation(s)
- Doris Hoffmann-Lamplmair
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
| | - Alexandra Gram
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
| | - Kerstin Krottendorfer
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
| | - Andreas Peyrl
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
| | - Ulrike Leiss
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
| | - Thomas Czech
- Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria.,Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Irene Slavc
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
| | - Thomas Pletschko
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
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5
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van Erp LME, Maurice-Stam H, Beek LR, Kremer LCM, den Hartogh JG, van Gorp M, Huizinga GA, Grootenhuis MA. Online cognitive-behavioral group intervention for young adult survivors of childhood cancer: a pilot study. J Psychosoc Oncol 2022; 41:518-538. [PMID: 36537338 DOI: 10.1080/07347332.2022.2150110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Young adult childhood cancer survivors (YACCS) are a vulnerable group in need of psychosocial support, but tailored interventions are lacking. AIM To examine feasibility and satisfaction, and to explore preliminary effectiveness of an online group intervention (Op Koers Online for YACCS) aimed at teaching active coping skills and providing peer-contact, thereby reducing and preventing psychosocial problems in YACCS. The intervention is based on psycho-education, cognitive behavioral therapy, and aspects of acceptance and commitment therapy. METHODS YACCS completed questionnaires pre- and post-intervention. Feasibility was based on attendance, drop-out, and an evaluation questionnaire was administered to assess satisfaction. Preliminary effectiveness was evaluated with the Mastery Scale, Illness Cognition Questionnaire, Distress Thermometer, Impact of Cancer - Childhood Survivors, and Pediatric Quality of Life Inventory. Preliminary effectiveness was investigated by testing differences on the psychosocial outcomes (coping and psychosocial wellbeing) between T0 and T1 within respondents, using paired samples t tests and Cohen's d. RESULTS 10 YACCS participated in the intervention and completed all questionnaires. There was no drop-out; 90% of participants attended five out of six sessions. Overall, participants were satisfied with the intervention; 7.6 on a 0-10 scale. Distress (Cohen's d=-.6, p=.030) and feelings of helplessness (Cohen's d=-.8, p=.001) reduced from T0 to T1, while self-efficacy (Cohen's d=.8, p=.013,) improved. Other outcomes displayed small effects, but did not change significantly. CONCLUSIONS This first, small pilot study showed short-term decrease in distress and feelings of helplessness and improvement of self-efficacy. Op Koers Online was positively evaluated by YACCS and course leaders, filling a gap in psychosocial services for YACCS.
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Affiliation(s)
- Loes M E van Erp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Laura R Beek
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jaap G den Hartogh
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Vereniging Kinderkanker Nederland, De Bilt, The Netherlands
| | - Marloes van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Gea A Huizinga
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Beatrix Children's Hospital, University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
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6
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Belson PJ, Eastwood JA, Brecht ML, Kim JW, Hays RD, Pike NA. Health-Related Quality of Life in Adolescent and Young Adult Retinoblastoma Survivors. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:342-357. [PMID: 35674414 PMCID: PMC9807776 DOI: 10.1177/27527530221073766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background: Retinoblastoma (RB) is a malignant intraocular tumor diagnosed in early childhood that requires extensive medical and surgical treatment at a young age. Health-related quality of life (HRQOL) is thought to be diminished due to visual impairment, facial deformities, and fear of recurrence or secondary cancer. However, few studies have identified variables associated with HRQOL among those with RB. Purpose: To compare HRQOL of adolescents and young adults (AYAs) with RB to matched controls and to identify predictors of HRQOL in RB survivors. Methods: Using a cross-sectional design, 198 AYAs (101 RBs and 97 controls) completed HRQOL (PROMIS®-29 profile) and psychosocial questionnaires (Rosenberg self-esteem scale, multidimensional scale of perceived social support, and Hollingshead index for socioeconomic status). Clinical variables (age at diagnosis, visual acuity, laterality, heredity, treatment regime, and anesthesia exposure) were extracted from the medical record. Correlates of HRQOL were estimated using linear regression models. Results: RB survivors reported similar HRQOL compared to controls. Physical function (p < .001), social support (p = .013), and self-esteem (p = .028) were lower in the RB group compared to controls. Visual acuity and self-esteem accounted for 52% of the variance in PROMIS physical health summary scores and self-esteem accounted for 38% of the variance in mental health summary scores. Conclusion: Despite deficits in physical function and self-esteem HRQOL in RB survivors was comparable to healthy counterparts. However, the majority of RB survivors in this study had normal visual acuity. Clinicians should explore ways to enhance self-esteem in RB survivors.
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Affiliation(s)
| | | | | | - Jonathan W. Kim
- Children’s Hospital, Los Angeles, CA, USA
- USC Roski Eye Institute, University of Southern California, Los
Angeles, CA, USA
| | - Ron D. Hays
- University of California, Los Angeles, CA, USA
- RAND Corporation, Santa Monica, CA, USA
| | - Nancy A. Pike
- Children’s Hospital, Los Angeles, CA, USA
- University of California, Los Angeles, CA, USA
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7
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Yang W, Jiang XX, Zhao XY, Mao PA. Treatment of RB-deficient retinoblastoma with Aurora-A kinase inhibitor. Kaohsiung J Med Sci 2022; 38:244-252. [PMID: 34741392 DOI: 10.1002/kjm2.12469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/26/2021] [Indexed: 11/10/2022] Open
Abstract
Retinoblastoma, also known as ocular cancer, usually affects children under the age of five. The standard of care for managing early-stage retinoblastoma is a combination of vincristine, carboplatin, and etoposide. However, this combination-based modality has limited applications owing to its side and late effects. Moreover, in advanced tumor stages, nearly 50% of patients would suffer a partial or full loss of vision. Therefore, therapies that preserve vision and reduce side effects are urgently required. Here, we focused mainly on the common loss-of-function (LOF) mutation of retinoblastoma gene 1 (RB1) in advanced retinoblastoma and investigated the synthetic lethality between RB1-LOF and Aurora kinase inhibition. We showed that Aurora kinase A inhibition could lead to cell mitotic abnormality and apoptosis, and demonstrated in vivo efficacy in a mouse model xenografted with RB1-deficient retinoblastoma. Our findings provide a promising druggable molecular target and potential clinical strategy for tackling retinoblastoma disease.
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Affiliation(s)
- Wen Yang
- Department of Ophthalmology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Xing-Xiu Jiang
- Department of Ophthalmology, Changzhou Jintan First People's Hospital, Changzhou, China
| | - Xiao-Yan Zhao
- Department of Ophthalmology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Ping-An Mao
- Department of Ophthalmology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
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8
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Söntgerath R, Däggelmann J, Kesting SV, Rueegg CS, Wittke TC, Reich S, Eckert KG, Stoessel S, Chamorro-Viña C, Wiskemann J, Wright P, Senn-Malashonak A, Oschwald V, Till AM, Götte M. Physical and functional performance assessment in pediatric oncology: a systematic review. Pediatr Res 2022; 91:743-756. [PMID: 33859367 PMCID: PMC9064803 DOI: 10.1038/s41390-021-01523-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/26/2021] [Accepted: 03/29/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Research indicates reduced physical performance from diagnosis into survivorship of pediatric cancer patients. However, there is no systematic information or guideline available on the methods to assess physical performance and function in this population. The purpose was to systematically compile and describe assessments of physical performance and function in patients and survivors of pediatric cancer, including cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait and motor performance test batteries. METHODS We searched the databases PubMed, SPORTDiscus, and Cochrane Database and performed abstract and full-text selection of 2619 articles according to the Cochrane Handbook of Systematic Reviews. Information on patients characteristics, assessments, information on validity and reliability, and relevant references was extracted. RESULTS In summary, 63 different assessments were found in 149 studies including 11639 participants. Most studies evaluated cardiorespiratory fitness and muscle strength with the majority conducted off treatment. Some outcomes (e.g. speed) and diagnoses (e.g. neuroblastoma) were severely underrepresented. With the exception of gait, leukemia patients represented the largest group of individuals tested. CONCLUSIONS Insufficient data and patient heterogeneity complicate uniform recommendations for assessments. Our results support researchers and practitioners in selecting appropriate assessment to meet their specific research questions or individual daily practice needs. IMPACT This systematic review includes 149 studies and provides a comprehensive summary of 63 assessments to evaluate cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait or motor performance test batteries in patients and survivors of pediatric cancer. We present the most studied fields within the pediatric cancer population, which are cardiorespiratory fitness and muscle strength, off treatment phase, and leukemia patients. We propose research priorities by identification of subgroups in terms of cancer type, phase of treatment, and outcome of interest that are underrepresented in studies currently available.
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Affiliation(s)
- Regine Söntgerath
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - Julia Däggelmann
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiology and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Sabine V Kesting
- Institute of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
- Kinderklinik München Schwabing, TUM School of Medicine, Department of Pediatrics and Children's Cancer Research Center, Technical University of Munich, Munich, Germany
| | - Corina S Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | | | - Simon Reich
- Working Group Exercise Oncology Division of Medical Oncology, University Clinic Heidelberg and National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Katharina G Eckert
- Department of Health Management & Public Health, IST University of Applied Sciences Düsseldorf, Düsseldorf, Germany
| | - Sandra Stoessel
- Center for Pediatric and Adolescent Medicine, Childhood Cancer Center, University Medical Center Mainz, Mainz, Germany
| | | | - Joachim Wiskemann
- Working Group Exercise Oncology Division of Medical Oncology, University Clinic Heidelberg and National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Peter Wright
- Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford, UK
| | - Anna Senn-Malashonak
- Department of Pediatric Oncology, Hematology and Hemostaseology, Goethe University Clinic Frankfurt, Frankfurt am Main, Frankfurt, Germany
| | - Vanessa Oschwald
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiology and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Anne-Marie Till
- Department of Pediatric Hematology and Oncology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Miriam Götte
- Department of Pediatric Hematology and Oncology, University Hospital Essen, Pediatrics III, Essen, Germany.
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9
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Streckmann F, Balke M, Cavaletti G, Toscanelli A, Bloch W, Décard BF, Lehmann HC, Faude O. Exercise and Neuropathy: Systematic Review with Meta-Analysis. Sports Med 2021; 52:1043-1065. [PMID: 34964950 DOI: 10.1007/s40279-021-01596-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Peripheral neuropathies are a prevalent, heterogeneous group of diseases of the peripheral nervous system. Symptoms are often debilitating, difficult to treat, and usually become chronic. Not only do they diminish patients' quality of life, but they can also affect medical therapy and lead to complications. To date, for most conditions there are no evidence-based causal treatment options available. Research has increased considerably since the last review in 2014 regarding the therapeutic potential of exercise interventions for patients with polyneuropathy. OBJECTIVE Our objective in this systematic review with meta-analysis was to analyze exercise interventions for neuropathic patients in order to update a systematic review from 2014 and to evaluate the potential benefits of exercise on neuropathies of different origin that can then be translated into practice. METHODS Two independent reviewers performed a systematic review with meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Inclusion criteria according to the PICOS approach were: neuropathic patients, exercise interventions only, an inactive or non-exercising control group, and solely randomized controlled trials with the following outcome parameters: neuropathic symptoms, balance parameters, functional mobility, gait, health-related quality of life, and HbA1c (glycated hemoglobin). RESULTS A total of 41 randomized, controlled trials met all inclusion criteria, 20 of which could be included in the quantitative analysis. Study quality varied from moderate to high. Current data further support the hypothesis that exercise is beneficial for neuropathic patients. This is best documented for patients with diabetic peripheral neuropathy (DPN) (27 studies) as well as for chemotherapy-induced peripheral neuropathy (CIPN) (nine studies), while there are only few studies (five) on all other causes of neuropathy. We found standardized mean differences in favor of the exercise group of 0.27-2.00 for static balance, Berg Balance Scale, Timed-up-and-go-test, nerve conduction velocity of peroneal and sural nerve as well as for HbA1c in patients with DPN, and standardized mean differences of 0.43-0.75 for static balance, quality of life, and neuropathy-induced symptoms in patients with CIPN. CONCLUSION For DPN, evidence-based recommendations can now be made, suggesting a combination of endurance and sensorimotor training to be most beneficial. For patients with CIPN, sensorimotor training remains the most crucial component. For all other neuropathies, more high-quality research is needed to derive evidence-based recommendations. Overall, it seems that sensorimotor training has great potential to target most neuropathies and combined with endurance training is therefore currently the best treatment option for neuropathies. REGISTRATION NUMBER: (PROSPERO 2019 CRD42019124583)/16.04.2019.
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Affiliation(s)
- Fiona Streckmann
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland. .,Department of Oncology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland. .,Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany.
| | - Maryam Balke
- Department of Early Neurological and Interdisciplinary Rehabilitation, St. Marien-Hospital, Kunibertskloster 11-13, 50668, Cologne, Germany.,Department of Rehabilitation Sciences, University of Witten/Herdecke, Holthauser Talstraße 2, 58256, Ennepetal, Germany
| | - Guido Cavaletti
- Experimental Neurology Unit, School of Medicine and Surgery and Milan Center for Neuroscience, University of Milano-Bicocca, via Cadore 48, 20900, Monza, Italy
| | - Alexandra Toscanelli
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Wilhelm Bloch
- Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Bernhard F Décard
- Department of Medicine, Neurologic Clinic and Policlinic, University Hospital Basel and University of Basel, 4031, Basel, Switzerland.,Department of Biomedicine, Neurologic Clinic and Policlinic, University Hospital Basel and University of Basel, 4031, Basel, Switzerland.,Department of Clinical Research, Neurologic Clinic and Policlinic, University Hospital Basel and University of Basel, 4031, Basel, Switzerland
| | - Helmar C Lehmann
- Department of Neurology, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
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10
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Balcerek M, Sommerhäuser G, Schilling R, Hölling H, Klco-Brosius S, Borgmann-Staudt A. Health-related quality of life of children born to childhood cancer survivors in Germany. Psychooncology 2021; 30:1866-1875. [PMID: 34156134 DOI: 10.1002/pon.5752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/17/2021] [Accepted: 06/15/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Rising childhood cancer survival rates have increased the importance of health-related quality of life (HRQL) assessment. While survivors show comparable HRQL to peers, concerns that cancer treatment could impact the health of prospective children were reported. No previous publications address HRQL of childhood cancer survivor offspring. METHODS We assessed survivor offspring HRQL using the parental KINDL questionnaire. Matched-pair analysis was conducted with data from the general population (KiGGS study) using age, gender and education (1:1, n = 1206 cases). Multivariate analyses were conducted to detect the influence of parental diagnose and treatment on offspring HRQL. RESULTS Overall, within KINDL dimensions, survivors reported comparable to higher HRQL for their children than the general population. Survivor parents reported significantly (p < 0.001) higher psychological (86.7% vs. 83.0%, Cohen's d = 0.3) and self-esteem (79.1% vs. 73.3%, Cohen's d = 0.5) well-being scores for younger children (3-6-year-olds). As time since diagnosis increased, parents reported higher well-being scores. Accordingly, recently diagnosed survivors reported significantly lower psychological well-being scores (p = 0.28; OR = 0.457; 95% CI = 0.228-0.918) for their children. With increasing age, average HRQL scores decreased in both cohorts; yet, this drop was less pronounced for survivor offspring. The biggest difference between age groups (7-10- vs. 14-17-year-olds) was found for school-specific well-being (6.2-point drop in survivor offspring vs. 18.2-point drop in KiGGS offspring). CONCLUSION Comparable to higher parentally assessed HRQL was reported for survivor offspring compared to peers. These findings are reassuring and consistent with self-reported HRQL in childhood cancer survivors. Type of parental cancer diagnosis and treatment showed no negative impact on offspring HRQL.
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Affiliation(s)
- Magdalena Balcerek
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Greta Sommerhäuser
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ralph Schilling
- Institute of Biometry and Clinical Epidemiology, Charité-Univseristätsmedzin Berlin, Berlin, Germany.,Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Heike Hölling
- Division of Epidemiology and Health Monitoring, Robert Koch-Institute Berlin, Berlin, Germany
| | - Stephanie Klco-Brosius
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Anja Borgmann-Staudt
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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11
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Bashore L, Hobbie W. Emerging and Ongoing Survivorship Challenges Among Childhood Cancer Survivors and Providing Risk-Based Focused Follow-Up Care. Semin Oncol Nurs 2021; 37:151163. [PMID: 34144848 DOI: 10.1016/j.soncn.2021.151163] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To provide a summary of the emerging and ongoing survivorship challenges facing childhood, adolescent, and young adult cancer survivors and their families. DATA SOURCES Research and review articles, websites, and clinical guidelines specific to childhood cancer survivorship were used. CONCLUSION Many challenges exist in assuring quality long-term follow-up and risk-based screening for childhood cancer survivors. Although many childhood cancer survivors survive well into adulthood, they are at risk for a vast number of later complications of their cancer treatment necessitating annual cancer surveillance. In addition, many childhood cancer survivors are not engaging in long-term follow-up recommendations for clinic attendance, risk-based surveillance, and screening for potentially life-ending events. Pediatric oncology nurses and advanced practice nurses have played an enormous role in the design of childhood cancer survivorship programs and are an integral member of the multidisciplinary health care team who care for this population. Nurses have an obligation to continue to advance the survivorship care of childhood cancer survivors and lead interventional opportunities to improve the lifelong health-related quality of life and overall physical health. IMPLICATIONS FOR NURSING PRACTICE Pediatric oncology nurses and advanced practice registered nurses must have a working knowledge of the many late effects that childhood cancer treatment has on the long-term health of childhood cancer survivors. Nurses are well-placed in positions to continue the efforts begun more than 2 decades prior by pediatric oncology nurses who saw the value and necessity of designated survivorship programs.
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Affiliation(s)
| | - Wendy Hobbie
- Children's Hospital of Philadelphia, Philadelphia, PA
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12
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van Erp LME, Maurice-Stam H, Kremer LCM, Tissing WJE, van der Pal HJH, de Vries ACH, van den Heuvel-Eibrink MM, Versluys BAB, Loonen JJ, Bresters D, Louwerens M, van der Heiden-van der Loo M, van den Berg MH, Ronckers CM, van der Kooi ALLF, van Gorp M, van Dulmen-den Broeder E, Grootenhuis MA. Health-related quality of life in Dutch adult survivors of childhood cancer: A nation-wide cohort study. Eur J Cancer 2021; 152:204-214. [PMID: 34119924 DOI: 10.1016/j.ejca.2021.04.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/20/2021] [Accepted: 04/30/2021] [Indexed: 01/16/2023]
Abstract
AIM To investigate the health-related quality of life (HRQOL) of Dutch adult childhood cancer survivors (CCS) and to identify risk factors of impaired HRQOL. METHODS Adult CCS (age >18, diagnosed <18, ≥5 years since diagnosis) from the Dutch LATER registry completed the Medical Outcome Study Short Form 36 (SF-36) to measure HRQOL and provided sociodemographic characteristics. Age-adjusted mean SF-36 scale scores of CCS were compared to the Dutch general population for men and women separately using t-tests, with effect size d. Multivariate logistic regression models were built to identify sociodemographic and cancer-related risk factors for impaired physical and mental HRQOL. RESULTS Both male and female CCS (N = 2301, mean age = 35.4 years, 49.6% female) reported significantly (p ≤ .005) worse HRQOL than the general population on almost all scales of the SF-36 (-.11 ≤ d ≤ -.56). Largest differences were found on vitality and general health perceptions. Significant risk factors (p ≤ .05) for impaired physical HRQOL were female sex, older age at diagnosis, not having a partner, low educational attainment, disease recurrence and exposure to radiotherapy, specifically to lower extremity radiation. Odds ratios (ORs) ranged from 1.6 to 3.7. Significant risk factors for impaired mental HRQOL were age 26-35 years, male sex, not having a partner and low educational attainment. ORs ranged from 1.3 to 2.0. CONCLUSION Adult CCS had worse HRQOL than the general population. CCS most at risk were those with low educational attainment and without a partner. Adult CCS could benefit from routine surveillance of their HRQOL. Special attention for CCS' vitality and health perceptions and beliefs is warranted.
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Affiliation(s)
- L M E van Erp
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - H Maurice-Stam
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - L C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - W J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, the Netherlands
| | - H J H van der Pal
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - A C H de Vries
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, the Netherlands
| | - M M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, the Netherlands
| | - B A B Versluys
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, the Netherlands
| | - J J Loonen
- Radboud University Medical Center, Nijmegen, the Netherlands
| | - D Bresters
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Leiden University Medical Center, Leiden, the Netherlands
| | - M Louwerens
- Leiden University Medical Center, Leiden, the Netherlands
| | | | - M H van den Berg
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Paediatrics, Amsterdam, the Netherlands
| | - C M Ronckers
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Brandenburg Medical School, Institute of Biostatistics and Registry Research, Neuruppin, Germany
| | - A L L F van der Kooi
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Erasmus MC, University Medical Centre, Rotterdam, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology
| | - M van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - E van Dulmen-den Broeder
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Amsterdam UMC/location VUmc, Amsterdam, the Netherlands
| | - M A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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13
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An evaluation of participation restrictions and associated factors via the ICF-CY framework in children with acute lymphoblastic leukemia receiving maintenance chemotherapy. Eur J Pediatr 2021; 180:1081-1088. [PMID: 33063136 DOI: 10.1007/s00431-020-03833-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/14/2020] [Accepted: 10/09/2020] [Indexed: 10/23/2022]
Abstract
Our aim was to determine impairments in physical functions, activity limitations, and participation restrictions with the International Classification of Functioning, Disability and Health version for Children and Youth (ICF-CY) framework in children with acute lymphoblastic leukemia (ALL) receiving treatment. Physical functions were assessed in terms of pain level, fatigue level, handgrip strength, and motor proficiency. Fine motor activities and lower extremity performance were assessed to determine activity limitations. Participation was assessed with a patient-reported questionnaire. Thirty children with ALL (mean age: 8.45 ± 3.33 years) were included. Pain and fatigue level were mild. Poor handgrip strength was found; their mean handgrip strength was 60% of the normative. Fifty-six percent of the children had below-average motor performance. Participation scores were considerably high, except for sport and physical functioning sub-score. Participation level was positively associated with bilateral coordination and duration after diagnosis, while negatively correlated with pain and fatigue level (p ˂ 0.05).Conclusion: The ICF-CY-based evaluation was useful to understand children's limitations in everyday life. Children with ALL need supportive interventions during treatments in terms of physical functioning and participation in activities. Children with ALL with higher pain and fatigue, poor bilateral coordination, and who were in earlier period after diagnosis had higher risk for participation restriction. What is Known: • Children with ALL had physical functioning limitations on treatments. • Participation restrictions were described in children with ALL off treatment. What is New: • The ICY-CY-based health and functioning evaluation allows health care professionals to globally determine limitations of everyday life in children with ALL on treatment. • Impairments in physical functions, pain severity, fatigue severity, and duration after diagnosis are associated with participation to everyday life in children with ALL on treatment.
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14
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Benzing V, Siegwart V, Spitzhüttl J, Schmid J, Grotzer M, Roebers CM, Steinlin M, Leibundgut K, Everts R, Schmidt M. Motor ability, physical self-concept and health-related quality of life in pediatric cancer survivors. Cancer Med 2021; 10:1860-1871. [PMID: 33527768 PMCID: PMC7940246 DOI: 10.1002/cam4.3750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/05/2020] [Accepted: 12/15/2020] [Indexed: 12/31/2022] Open
Abstract
Background Cancer survivorship is frequently associated with severe late effects. However, research into pediatric cancer survivors on late effects in motor ability, physical self‐concept and their relationship to quality of life is limited. Methods Using multiple regression analyses, 78 pediatric cancer survivors and 56 typically developing children were compared in motor ability, physical self‐concept and health‐related quality of life. In addition, mediational multi‐group analyses between motor ability (independent variable), physical self‐concept (mediator) and quality of life (dependent variable) were calculated. Results Pediatric cancer survivors had a lower motor ability (gHedges = 0.863), a lower physical self‐concept with regard to several scales of the PSDQ‐S (gHedges = 0.318–0.764) and a higher relative risk for a below average quality of life than controls (RR = 1.44). Children with a history of cancer involving the central nervous system showed poorer motor ability compared to those without central nervous system involvement (gHedges = 0.591). Furthermore, the physical self‐concept significantly mediated the relationship between motor ability and quality of life in pediatric cancer survivors but not in typically developing children. Conclusions Results show the importance of monitoring and supporting the development of motor ability in the aftercare of pediatric cancer survivors. Physical activity interventions may be advisable to prevent physical activity‐related late effects and potentially improve related psychosocial variables such as quality of life.
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Affiliation(s)
- Valentin Benzing
- Institute of Sport Science, University of Bern, Bern, Switzerland.,Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Valerie Siegwart
- Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Janine Spitzhüttl
- Division of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Psychology, University of Bern, Bern, Switzerland
| | - Jürg Schmid
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Michael Grotzer
- Division of Pediatric Oncology, University Children's Hospital Zurich, Zurich, Switzerland
| | | | - Maja Steinlin
- Division of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kurt Leibundgut
- Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Regula Everts
- Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mirko Schmidt
- Institute of Sport Science, University of Bern, Bern, Switzerland
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15
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Hobusch GM, Keusch F, Tsuchiya H, Joyce M, Windhager R. What Opinions Do Tumor Reconstructive Surgeons Have about Sports Activity after Megaprosthetic Replacement in Hip and Knee? Results of the MoReSports Expert Opinion Online Survey. J Clin Med 2020; 9:E3638. [PMID: 33198264 PMCID: PMC7698049 DOI: 10.3390/jcm9113638] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/17/2022] Open
Abstract
Sports activity has many benefits in cancer survivors. A key one is having sport activity contribute to the well-being of the individual. However, there are no guidelines about the intensity and kind of postoperative mobility workouts after hip or knee megaprosthetic treatment. Opinion research about sports after modular bone and joint replacement may provide an understanding of surgeons' attitudes on sports activity after megaprostheses of the hip and knee joint. A web survey with members of three international professional organizations of orthopedic tumor reconstructive surgeons was conducted between September 2016 and January 2018. Members were invited via personalized emails by the European Musculoskeletal Oncology Society (EMSOS), the International Society of Limb Salvage (ISOLS), and the Musculoskeletal Tumor Society (MSTS). The questionnaire included 26 questions. A total of 149 surgeons started the survey, and 76 finished the entire survey (American Association for Public Opinion Research (AAPOR) second response rate (RR2) EMSOS: 12.3%; ISOLS: 21.9%; MSTS: n/a). More than half of the respondents encourage sarcoma survivors after megaprosthetic treatment to reach an activity level that would allow them to regularly participate in active sporting events of University of California, Los Angeles (UCLA) activity level 7 and higher. Orthopedic tumor reconstructive surgeons do fear a number of complications (periprosthetic fracture, allograft failure/fracture, loosening, prosthetic or bearing failure, and early polyethylene wear) due to sports activity after modular bone-joint replacement, but they actually witness fewer complications than they conceptually anticipated. According to the surgeons' opinions, between four to seven types of sports after surgery could reasonably be recommended depending on the type of hip or knee procedures. This survey provides insights into opinions on what could be recommended, what could be allowed if surgeons and their patients agree on the potential negative outcome, and which sports should definitely not be allowed after hip and knee megaprostheses.
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Affiliation(s)
- Gerhard M. Hobusch
- Department of Orthopaedic and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria;
| | - Florian Keusch
- Department of Sociology, University of Mannheim, 68131 Mannheim, Germany;
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa 920-1192, Ishikawa, Japan;
| | - Michael Joyce
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44106, USA;
| | - Reinhard Windhager
- Department of Orthopaedic and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria;
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16
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Lönnerblad M, Van't Hooft I, Blomgren K, Berglund E. Nationwide, population-based study of school grades in practical and aesthetic subjects of children treated for brain tumour. BMJ Paediatr Open 2020; 4:e000619. [PMID: 32201746 PMCID: PMC7073787 DOI: 10.1136/bmjpo-2019-000619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/08/2020] [Accepted: 02/11/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Children treated for brain tumour (hereafter termed paediatric brain tumour survivors (PBTS)) often need extra support in school because of late-appearing side effects after their treatment. We explored how this group of children perform in the five practical and aesthetic (PRAEST) subjects: home and consumer studies, physical education and health, art, crafts and music. METHODS In this nationwide population-based study of data from the Swedish Childhood Cancer Registry and Statistics Sweden, we included 475 children born between 1988 and 1996, diagnosed with a brain tumour before their 15th birthday. We compared their grades in PRAEST subjects with those of 2197 matched controls. We also investigated if there were any differences between girls and boys, children diagnosed at different ages, and children with high-grade or low-grade tumours. RESULTS The odds for failing a subject were two to three times higher for girls treated for a brain tumour compared with their controls in all five PRAEST subjects, whereas there were no significant differences between the boys and their controls in any subject. PBTS had lower average grades from year 9 in all PRAEST subjects, and girls differed from their controls in all five subjects, while boys differed in physical education and health and music. PBTS treated for high-grade tumours neither did have significantly different average grades nor did they fail a subject to a significantly higher extent than PBTS treated for low-grade tumours. CONCLUSIONS Children treated for a brain tumour, especially girls, are at risk of lower average grades or failing PRAEST subjects. All children treated for brain tumour may need extra support as these subjects are important for their well-being and future skills.
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Affiliation(s)
- Malin Lönnerblad
- Department of Special Education, Stockholm University, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Van't Hooft
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Klas Blomgren
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Pediatric Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Berglund
- Department of Special Education, Stockholm University, Stockholm, Sweden
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17
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Roser K, Mader L, Baenziger J, Sommer G, Kuehni CE, Michel G. Health-related quality of life in Switzerland: normative data for the SF-36v2 questionnaire. Qual Life Res 2019; 28:1963-1977. [PMID: 30848444 PMCID: PMC6571102 DOI: 10.1007/s11136-019-02161-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2019] [Indexed: 11/28/2022]
Abstract
Purpose Health-related quality of life (HRQOL) is an important concept to describe well-being of the general population and persons with diseases. The short form-36 (SF-36) is a widely used questionnaire assessing self-reported HRQOL in eight health domains. The aims of this study were to provide normative data for the SF-36 version 2 (SF-36v2) for all language regions in Switzerland and weighting coefficients to calculate two summary measures for physical and mental health. Methods A random representative (regarding age, sex, and language region) sample of people living in Switzerland aged 18–75 years in 2015 was eligible for our questionnaire survey. We calculated the eight health domain subscales for different subsamples based on sociodemographic characteristics. Two summary measures for physical and mental health were derived using data-based factor score coefficients and calculated for the subsamples. Results A total of 1209 persons completed the SF-36v2 (mean age 48.7 years, 58.1% women). The SF-36v2 was valid and reliable in Switzerland. Physical health was better in men (p = 0.012) and younger persons (p < 0.001). Mental health was better in men (p < 0.001) and older persons (p < 0.001). Regarding regional differences, we found better physical (p = 0.002) and mental (p < 0.001) health in German speaking persons compared to French and Italian speaking persons. Conclusions This paper presents the first SF-36v2 normative data for Switzerland, which are based on a recent study in a representative sample. Our normative data and weighting coefficients will enable future studies to compare HRQOL assessed by the SF-36 in healthy and diseased persons to a representative Swiss sample. Electronic supplementary material The online version of this article (10.1007/s11136-019-02161-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katharina Roser
- Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland
| | - Luzius Mader
- Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland
| | - Julia Baenziger
- Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland
| | - Grit Sommer
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Department of Paediatrics, University Children's Hospital, University of Bern, Bern, Switzerland
| | - Claudia E Kuehni
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Department of Paediatrics, University Children's Hospital, University of Bern, Bern, Switzerland
| | - Gisela Michel
- Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland.
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18
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Hobusch GM, Cernakova M, Puchner SE, Kolb A, Panotopoulos J, Windhager R. Sports activity after soft tissue sarcoma of the lower extremity. Disabil Rehabil 2019; 42:14-19. [DOI: 10.1080/09638288.2018.1520929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Gerhard M. Hobusch
- Department of Orthopaedic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Miroslava Cernakova
- Department of Orthopaedic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Stephan E. Puchner
- Department of Orthopaedic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Alexander Kolb
- Department of Orthopaedic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Joannis Panotopoulos
- Department of Orthopaedic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopaedic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
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19
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Whole-Body Vibration Training Designed to Improve Functional Impairments After Pediatric Inpatient Anticancer Therapy: A Pilot Study. Pediatr Phys Ther 2018; 30:341-349. [PMID: 30277971 DOI: 10.1097/pep.0000000000000536] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE To assess a whole-body vibration (WBV) intervention for children after cancer treatment. METHODS Eleven children after inpatient anticancer therapy participated in a 12-week supervised WBV intervention, which consisted of one 9- to 13-minute WBV session per week, with 5 to 9 minutes' overall vibration time. Feasibility was defined as the ability to participate in WBV training without reporting adverse events. The number of offered and completed training sessions, program acceptance, and measures of function were assessed. RESULTS Nine participants completed the WBV intervention without any WBV-related adverse events. The adherence rate was 87.96%. Only minor side effects were reported and there was general program acceptance. We found indications that WBV has positive effects on knee extensor strength and active ankle dorsiflexion range of motion. CONCLUSIONS WBV was feasible, safe, and well received among children after inpatient anticancer therapy. No health deteriorations were observed. Positive effects need to be confirmed in future trials.
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20
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Effect of inpatient rehabilitation on activities of daily living in pediatric cancer patients in Japan. Int J Rehabil Res 2018; 41:146-151. [DOI: 10.1097/mrr.0000000000000280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Huang IC, Jones CM, Brinkman TM, Hudson MM, Srivastava DK, Li Y, Robison LL, Krull KR. Development of the functional social network index for adolescent and young adult cancer survivors. Cancer 2018. [PMID: 29517807 DOI: 10.1002/cncr.31278] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND To the authors' knowledge, social network status in adolescent and young adult (AYA) cancer survivors has not been adequately studied to date. The authors developed and validated a functional social network index (FSNI) for AYA survivors, and compared its performance with that of 2 traditional indices (density and betweenness centrality). METHODS A total of 102 AYA survivors and 102 noncancer controls who were matched for age, sex, and race were recruited from an Internet panel. Each participant reported relationships with up to 25 close friends and/or relatives. The authors developed a FSNI with reported marital status, contact frequency with friends/relatives, available resources for emotional and tangible support, and available resources for physical activity and weight management advice. Linear regression was used to analyze associations between the FSNI and cancer diagnoses, treatments, and coping skills. RESULTS Based on the FSNI, survivors were found to have more available resources for emotional support (beta [b] = 3.02; P = .003), tangible support (b = 4.17; P<.001), physical activity advice (b = 3.94; P<.001), and weight management advice (b = 4.10; P<.001) compared with noncancer controls. Survivors of lymphoma had the largest FSNI, whereas survivors of central nervous system malignancies had the smallest (b = 2.77; P = .02). A higher FSNI was associated with better coping skills: less denial (b = 0.10; P = .01), using emotional support (b = 0.08; P = .04), using instrumental support (b = 0.12; P<.001), less behavioral disengagement (b = 0.08; P = .04), venting of emotions (b = 0.10; P = .004), positive reframing (b = 0.12; P = .003), planning for the future (b = 0.08; P = .03), and religious engagement (b = 0.16; P<.001). Density and betweenness centrality indices demonstrated neither significant differences in social networks between cancer survivors and controls (all P values >.05) nor significant associations with coping skills (all P values >.05). CONCLUSIONS The FSNI appears to provide a better social network assessment for AYA cancer survivors than traditional indices. Cancer 2018;124:2220-7. © 2018 American Cancer Society.
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Affiliation(s)
- I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Conor M Jones
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Tara M Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - D Kumar Srivastava
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
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22
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Hartman A, Pluijm SMF, Wijnen M, Neggers SJCMM, Clemens E, Pieters R, van den Heuvel-Eibrink MM. Health-related fitness in very long-term survivors of childhood cancer: A cross-sectional study. Pediatr Blood Cancer 2018; 65. [PMID: 29271565 DOI: 10.1002/pbc.26907] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 10/31/2017] [Accepted: 10/31/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Impairment of health-related physical fitness (HRPF) in survivors of acute lymphoblastic leukemia has been shown. However, evidence of impairment in survivors of other pediatric malignancies and possible risk factors is limited. PARTICIPANTS AND METHODS HRPF of 17 survivors of pediatric acute myeloid leukemia (AML), 26 survivors of neuroblastoma (NBL), 28 survivors of Wilms tumor (WT) (median age 28.8 [18.8-62.6] years) after a median follow-up time of 24.5 (6.5-43.6) years, and 74 healthy controls (median age 26.9 [17.9-61.7] years). Risk factors were investigated. Testing included submaximal cardiovascular endurance (6-Minute Walk Test (6 MWT), flexibility, and muscle strength. RESULTS Results are expressed as mean (standard error). Survivors scored significantly lower than controls on the 6 MWT (588 ± 6.1 m vs. controls 611 ± 6.0 m; P = 0.008), on side flexion of the trunk (20.1 ± 0.4 cm vs. controls 22.4 ±0.4 cm; P < 0.001), and on vertical jump (39.7 ± 0.8 cm vs. controls 43.8 ± 0.8 cm; P < 0.001). Survivors of AML had lower scores on the 6 MWT (563 ± 12.4 m) than survivors of NBL (585 ± 9.9 m) and survivors of WT (606 ± 9.6 m), P = 0.046. Being a survivor, higher body mass index (BMI) and no participation in sports were independently associated with lower scores on the 6 MWT. CONCLUSION Survivors of NBL, WT, and especially AML have impaired HRPF. Higher BMI and physical inactivity at adult age appeared prominent risk factors for impaired HRPF in these survivors.
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Affiliation(s)
- Annelies Hartman
- Department of Pediatric Oncology and Hematology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Saskia M F Pluijm
- Department of Pediatric Oncology and Hematology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Mark Wijnen
- Department of Pediatric Oncology and Hematology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.,Section of Endocrinology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Sebastian J C M M Neggers
- Department of Pediatric Oncology and Hematology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.,Section of Endocrinology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Eva Clemens
- Department of Pediatric Oncology and Hematology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Rob Pieters
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Department of Pediatric Oncology and Hematology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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23
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Ahomäki R, Harila-Saari A, Parkkola K, Matomäki J, Lähteenmäki PM. Compulsory military service as a measure of later physical and cognitive performance in male survivors of childhood cancer. Acta Oncol 2017; 56:1712-1719. [PMID: 28712313 DOI: 10.1080/0284186x.2017.1351037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Compromised physical fitness and cognitive difficulties have been reported as late effects of cancer treatment during childhood. To assess this issue, the military rankings of cancer survivors in medical checkups at call-up, and conscripts' physical and cognitive performance during the first weeks of compulsory military education were compared to those of matched population controls without a history of cancer. MATERIAL AND METHODS A total of 1680 male patients born between 1960 and 1992 with a malignancy diagnosed before the age of 16 who were alive at the call-up age (18 years) were identified using the Finnish Cancer Registry, and five age, sex and place of residence matched controls for each patient using the Population Register Centre. Data on military service were gathered from Finnish Defense Forces. A conditional logistic regression analysis, the GEE-method with the cumulative logit link function, the chi-square test, the chi-square test for trend and a one-way analysis of variance were used in different analyses. RESULTS Cancer survivors were exempted from military service more often than the controls (p < .001). The fit-for-service frequency was highest for survivors of kidney tumors (68%) and lowest after irradiated brain tumors (19%). In service, the results of the 12-min running test were poorer than those of controls for leukemia/non-Hodgkin lymphoma (p = .03) and brain tumor (p = .01) survivors. Interestingly, the standing long-jump test was the only muscle test for which survivor groups performed worse than controls. Performance on cognitive tests only differed from controls in brain tumor survivors. CONCLUSIONS Exemption from service is still common under the current guidelines, but fit-for-service survivors do well in military education. These results can be used for reassuring survivors that completion of military service is possible for those fulfilling the national general guidelines for military fitness.
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Affiliation(s)
- Ritva Ahomäki
- Department of Pediatric and Adolescent Medicine, Turku University Hospital and Turku University, Turku, Finland
| | - Arja Harila-Saari
- Childhood Cancer Research Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland
| | - Kai Parkkola
- School of Medicine, University of Tampere, Tampere, Finland
| | - Jaakko Matomäki
- Department of Pediatric and Adolescent Medicine, Turku University Hospital and Turku University, Turku, Finland
| | - Päivi M. Lähteenmäki
- Department of Pediatric and Adolescent Medicine, Turku University Hospital and Turku University, Turku, Finland
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24
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Gupta P, Jalali R. Long-term Survivors of Childhood Brain Tumors: Impact on General Health and Quality of Life. Curr Neurol Neurosci Rep 2017; 17:99. [PMID: 29119343 DOI: 10.1007/s11910-017-0808-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW We review and summarize the key issues affecting general health and quality of life (QOL) of pediatric long-term survivors of brain tumors. RECENT FINDINGS Long-term survivors of brain tumors are at risk of considerable late morbidity and mortality. Lengthening survival in brain tumors has highlighted the deep impact of tumor and its treatment on the physical, psychological, functional, and social health and QOL of these survivors. Evolution in tumor therapy including surgery, radiotherapy, and systemic therapies, etc., has the potential to mitigate this impact to some extent. Sensitization of health staff, policy makers, and the primary designers of clinical trials towards integration of QOL end points while measuring survival in brain tumor patients is the need of the hour. New developments in tumor therapeutics must not only provide quantitative gain but also improve the quality of survival in these long-term survivors. While majority of the issues presented pertain to survivorship in pediatric brain tumor population, similar challenges are likely to exist in young adults surviving brain tumors as well.
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Affiliation(s)
- Priyamvada Gupta
- Neuro Oncology Group, Tata Memorial Centre, Tata Memorial Hospital, Dr Ernest Borges Road, Parel, Mumbai, 400 012, India
| | - Rakesh Jalali
- Neuro Oncology Group, Tata Memorial Centre, Tata Memorial Hospital, Dr Ernest Borges Road, Parel, Mumbai, 400 012, India.
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25
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Gallasch CH, Alexandre NM, Esteves SC, Gomes HF, da Rocha EC, Baptista PC. Limitations of workers diagnosed with cancer evaluated with Work Role Functioning Questionnaire-Br. Ecancermedicalscience 2017; 11:769. [PMID: 29062387 PMCID: PMC5636208 DOI: 10.3332/ecancer.2017.769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Indexed: 11/06/2022] Open
Abstract
The main subject of the current study is to look into the limitations found in individuals diagnosed with cancer, considered a public health problem, especially in developing countries where the impact of this disease is expected to account for 80% of 20 million new cases estimated worldwide by 2025. For some patients undergoing treatment, continuing to be professionally active is challenging especially considering that work fosters a purpose in life, a sense of contribution, distraction, and self-esteem, which aids in physical, cognitive, emotional, and interpersonal recovery. Within this context, the aim is to describe the limitations found in individuals with cancer, who have maintained their work activities in private service during radiotherapy treatment, through a descriptive study and a quantitative approach. The final sample of 51 participants was defined by non-probability convenience sampling, based on information from all patients admitted in that period, with a research protocol approved by the Research Ethics Committee. The assessment using the Brazilian version of the Work Role Functioning Questionnaire showed higher average work functioning indexes for social demand, with an average score of 94.33 (11.47). In turn, the worst indexes were registered in physical demand. No significant differences were observed between groups of treatment protocols in terms of WRFQ-Br scores. The work functioning assessment of workers diagnosed with cancer in radiotherapy using the WRFQ-Br showed higher scores for social demands and lower for physical demands. The preserved social performance may be linked to individual work functioning within the family, at work and, consequently, within society, given that the study included patients who maintained their work activities during the proposed treatment period, highlighting the social role of work for patients with cancer.
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Affiliation(s)
- Cristiane H Gallasch
- Faculty of Nursing of the Rio de Janeiro State University, Blv September 28, 157, 7th floor, Vila Isabel, Rio de Janeiro, Brazil
| | - Neusa Mc Alexandre
- Study Group on Occupational Health and Nursing Personnel (GESTES), School of Nursing, Av. Dr. Enéas de Carvalho Aguiar, 419, Cerqueira César, São Paulo, Brazil.,Study and Research Group for Occupational Health and Ergonomics, Campinas, São Paulo, Brazil
| | - Sergio Cb Esteves
- Faculty of Nursing of the State University of Campinas. City University Zeferino Vaz, s / n. Campinas, São Paulo, Brazil
| | - Helena F Gomes
- Faculty of Nursing of the Rio de Janeiro State University, Blv September 28, 157, 7th floor, Vila Isabel, Rio de Janeiro, Brazil
| | - Elaine Cl da Rocha
- Radiotherapy Section, Women's Hospital Professor Dr. José Aristodemo Pinotti - CAISM, State University of Campinas, City University Zeferino Vaz, s / n. Campinas, São Paulo, Brazil
| | - Patricia Cp Baptista
- Military Police Central Hospital in Rio de Janeiro, R. Estácio de Sá, 20, Estácio, Rio de Janeiro, Brazil.,School of Nursing of the University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 419, Cerqueira César, São Paulo, São Paulo, Brazil
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26
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What Sport Activity Levels Are Achieved in Patients After Resection and Endoprosthetic Reconstruction for a Proximal Femur Bone Sarcoma? Clin Orthop Relat Res 2017; 475:817-826. [PMID: 27020426 PMCID: PMC5289166 DOI: 10.1007/s11999-016-4790-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Limited information is available about sports activities of survivors after resection and reconstruction of primary malignant bone tumors with megaprostheses. Because patients often ask what activities are possible after treatment, objective knowledge about sports activities is needed to help assess the risks of sports participation and to help guide patients' expectations. QUESTIONS/PURPOSES The aims of this study were to evaluate (1) what proportion of patients with proximal-femoral megaprostheses placed as part of tumor reconstructions can perform sports; (2) what activity levels they achieved; and (3) whether sports activity levels are associated with an increased likelihood of revision. METHODS This retrospective study considered all 27 living patients in our institutional tumor registry with enduring proximal-femoral reconstructions performed more than 5 years ago who were between the ages of 11 and 49 years at the time of the reconstruction; seven were lost to followup and one was excluded because of paraplegia as a result of a car accident and another because of senile dementia; another two were excluded from statistics because of growing prostheses and skeletal immaturity at the time of followup, leaving 16 (11 male, five female) for analysis. Their mean age was 26 ± 12 years (range, 11-49 years) at surgery, and the mean followup was 18 ± 7 years (range, 5-27 years). Types of sports, frequency per week, duration of each sports session as well as the UCLA and modified Weighted Activity Score were assessed retrospectively by an independent assessor a median of 18 years (range, 5.3-27 years) after surgery. RESULTS Patients recalled that preoperatively 14 were practicing sports 5 (± 4) hours/week. At followup, 11 of the patients were practicing one or more sports activities 2 (± 3) hours/week on a regular basis. The preoperative UCLA and modified Weighted Activity Score levels of 9 and 6 fell to levels of 6 (p = 0.005) and 3 (p = 0.025), respectively, at followup. With the numbers of patients available for study, we could not determine that prosthetic failures were associated with sport activity levels. CONCLUSIONS Patients who survive primary malignant bone tumors in the proximal femur reconstructed by megaprostheses are able to perform some sports activities. The estimates of activity levels made in this study probably are best-case estimates, given that some patients were lost to followup; patients unaccounted for might not be doing as well as those represented here. Also, the degree to which sports participation influences implant durability remains, for the most part, unanswered; studies with more patients and longer followup will be needed to determine to what degree prosthesis survivorship relates to sporting activity levels. Most patients perform low-impact sports and at a lower level than they had preoperatively. Because this is a preliminary study of a select group of patients, further information is necessary to weight the benefits of higher sports activity levels against potential risks. If this can be confirmed in a larger number of patients, the information may guide surgeons in their discussion with patients preoperatively and give them some objective assessment of what to expect regarding sports activities. LEVEL OF EVIDENCE Level IV, therapeutic study.
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27
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Merz EL, Tomfohr-Madsen L. Sleep Disruption in Pediatric Cancer Survivors: Conceptual Framework and Opportunities for Clinical Assessment and Behavioral Treatment. Am J Lifestyle Med 2016; 12:311-323. [PMID: 32063816 DOI: 10.1177/1559827616681725] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 10/31/2016] [Accepted: 11/09/2016] [Indexed: 12/18/2022] Open
Abstract
Sleep disruption is a commonly reported consequence of cancer and its treatment in pediatric patients and survivors. This review summarizes common sleep concerns in this population and introduces a multidimensional framework of risk factors specific to childhood cancer that may interact to develop and maintain disrupted sleep. Based on the extant literature, parameters of the cancer and its treatment, physical and social environmental conditions both during and after treatment, changes to family behavior and norms, psychological factors and traumatic stress, and reduced physical activity are hypothesized to be the most pertinent risk factors for disrupted sleep in this population. Potential clinical assessment strategies and behavioral interventions relevant to these considerations are discussed, with reference to the behavioral model of insomnia. The review concludes by offering directions for research and clinical practice, including developing and testing comprehensive assessment tools, intervention effectiveness studies in both oncology and primary care clinics, and efforts to increase patient-provider communication about sleep in pediatric oncology.
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Affiliation(s)
- Erin L Merz
- Department of Psychology, California State University, Dominguez Hills, Carson, California (ELM).,Department of Psychology, University of Calgary and Department of Pediatrics, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada (LTM)
| | - Lianne Tomfohr-Madsen
- Department of Psychology, California State University, Dominguez Hills, Carson, California (ELM).,Department of Psychology, University of Calgary and Department of Pediatrics, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada (LTM)
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28
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Söntgerath R, Eckert K. Impairments of Lower Extremity Muscle Strength and Balance in Childhood Cancer Patients and Survivors: A Systematic Review. Pediatr Hematol Oncol 2016; 32:585-612. [PMID: 26558954 DOI: 10.3109/08880018.2015.1079756] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This review aims to summarize the evidence for impairments of muscle strength and balance during and after treatment for childhood cancer. Thirty-two articles, identified in scientific databases by means of a structured search for investigations of muscle strength and balance in pediatric cancer patients and survivors, are evaluated. A summary of results is given with respect to matching reporting items to provide a qualitative analysis of the evidence. The majority of the studies reached a level 3 rating according to Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 levels of evidence. Muscle strength and balance seem to be impaired in varying degrees depending on the diagnosis, treatment received, and time elapsed between treatment and evaluation. Drawing specific conclusions from the identified studies is difficult because of heterogeneous study samples and methods of research. Individual targeted exercise therapy programs during treatment and follow-up of childhood cancer could help to prevent and further diminish impairments of muscle strength and balance function among childhood cancer patients and survivors.
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Affiliation(s)
- Regine Söntgerath
- a Institute of Exercise and Public Health, Faculty of Sport Science , University of Leipzig , Leipzig , Germany.,b Department of Pediatric Oncology, Hematology and Hemostaseology , University Hospital Leipzig , Leipzig , Germany
| | - Katharina Eckert
- a Institute of Exercise and Public Health, Faculty of Sport Science , University of Leipzig , Leipzig , Germany
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29
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Sparrow J, Brennan R, Mao S, Ness KK, Rodriguez-Galindo C, Wilson M, Qaddoumi I. Participation in an occupational therapy referral program for children with retinoblastoma. J Pediatr Rehabil Med 2016; 9:117-24. [PMID: 27285804 PMCID: PMC4939593 DOI: 10.3233/prm-160372] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
PURPOSE Because retinoblastoma typically arises at a very young age, children are particularly vulnerable to vision impairment, associated developmental delays, and functional limitations. Limited information is available describing developmental delay and functional limitations in this population, necessitating supportive services including rehabilitation. The aims of this study were to describe the participation of children with newly diagnosed retinoblastoma in an occupational therapy program that identifies children in need of rehabilitation services. We also identify indications for referral to rehabilitation services among children with newly diagnosed retinoblastoma and enumerate the likelihood of these children receiving the recommended services. METHODS Twenty-two children participated in longitudinal occupational therapy assessments during the first year after diagnosis. RESULTS We recommended 1 or more types of rehabilitation services for 16 of 22 (72.7%) participants. Twelve of 16 (75%) received services. CONCLUSIONS The results of this pilot study indicate that implementing a prospective occupational therapy-screening program is feasible and results in identification and initiation of therapy services in some children with retinoblastoma. Developmental screenings and follow-up of children with retinoblastoma is strongly recommended.
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Affiliation(s)
- Jessica Sparrow
- Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Rachel Brennan
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Shenghua Mao
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kirsten K Ness
- Department of Epidemiology & Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Carlos Rodriguez-Galindo
- Department of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Matthew Wilson
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA.,Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Ibrahim Qaddoumi
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
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30
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Kesting SV, Götte M, Seidel CC, Rosenbaum D, Boos J. One in Four Questioned Children Faces Problems Regarding Reintegration Into Physical Education at School After Treatment for Pediatric Cancer. Pediatr Blood Cancer 2016; 63:737-9. [PMID: 26681662 DOI: 10.1002/pbc.25852] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 11/02/2015] [Indexed: 11/08/2022]
Abstract
Resumption of physical activity and reintegration into social surroundings after treatment for pediatric cancer is of high importance to recover from the burden of disease and treatment and to positively influence long-term health outcomes. Eighty-three children who had completed intensive treatment for pediatric cancer were surveyed regarding their participation in physical education at school (PES). The results show a concerning low rate of participation, particularly in children treated for pediatric bone tumors, and associated barriers. Reported reasons for quitting PES seem to be conquerable by individual and entity-related support to enable participation according to the children's desire.
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Affiliation(s)
- Sabine V Kesting
- Department of Pediatric Hematology and Oncology, University Hospital Münster, Münster, Germany
| | - Miriam Götte
- Department of Pediatric Hematology and Oncology, University Hospital Münster, Münster, Germany
| | - Corinna C Seidel
- Movement Analysis Lab, Institute of Experimental Musculoskeletal Medicine, University Hospital Münster, Münster, Germany
| | - Dieter Rosenbaum
- Movement Analysis Lab, Institute of Experimental Musculoskeletal Medicine, University Hospital Münster, Münster, Germany
| | - Joachim Boos
- Department of Pediatric Hematology and Oncology, University Hospital Münster, Münster, Germany
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31
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Slater ME, Kelly AS, Sadak KT, Ross JA. Active transportation in adult survivors of childhood cancer and neighborhood controls. J Cancer Surviv 2016; 10:11-20. [PMID: 25809159 PMCID: PMC4583837 DOI: 10.1007/s11764-015-0447-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 03/12/2015] [Indexed: 12/14/2022]
Abstract
PURPOSE Childhood cancer survivors (CCS) are at high risk of treatment-related late effects, including cardiovascular disease and diabetes, which can be exacerbated by inadequate physical activity (PA). Previous PA interventions targeting CCS have focused on the domain of leisure-time/recreational PA. Active transportation, another domain of PA, has not been described in CCS. Therefore, this study aimed to identify active transportation behaviors, barriers, and correlates in adult CCS. METHODS We recruited 158 adult CCS and 153 controls matched on age, sex, and neighborhood for a survey regarding active transportation behaviors and perceptions. Linear and logistic regression models accounting for correlation among matched participants were used. RESULTS Adult CCS engaged in similar levels of active transportation as controls (2.72 vs. 2.32 h/week, P = 0.40) despite perceiving greater health-related barriers (1.88 vs. 1.65 (measured on four-point Likert scale), P = 0.01). Marital/relationship status (odds ratio (OR) = 0.30, 95 % confidence interval (CI) = 0.11-0.81), planning/psychosocial barriers (OR = 0.15, 95 % CI = 0.04-0.53), and perceived neighborhood walkability (OR = 2.55, 95 % CI = 1.14-5.66) were correlates of active transportation among adult CCS, while objective neighborhood walkability (OR = 1.03, 95 % CI = 1.01-1.05) was a correlate among controls. CONCLUSIONS Results suggest adult CCS and controls utilize active transportation at approximately equal levels. Factors other than health, including perceived neighborhood walkability, are related to active transportation behaviors to a greater degree in adult CCS. IMPLICATIONS FOR CANCER SURVIVORS Interventions might consider promoting active transportation as a way to incorporate more PA into the daily lives of adult CCS. Such interventions will not be likely successful, however, without existing or improved neighborhood walkability/bikeability.
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Affiliation(s)
- Megan E Slater
- Division of Epidemiology and Clinical Research, Division of Pediatric Hematology/Oncology, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Aaron S Kelly
- Division of Epidemiology and Clinical Research, Division of Pediatric Hematology/Oncology, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Karim T Sadak
- Division of Epidemiology and Clinical Research, Division of Pediatric Hematology/Oncology, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Julie A Ross
- Division of Epidemiology and Clinical Research, Division of Pediatric Hematology/Oncology, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA
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32
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Affiliation(s)
- Robert M. Siegel
- The Center for Better Health and Nutrition; The Heart Institute; Cincinnati Children's Hospital Medical Center; Cincinnati OH USA
| | - Mary Kate Lockhart
- The Center for Better Health and Nutrition; The Heart Institute; Cincinnati Children's Hospital Medical Center; Cincinnati OH USA
| | - Christopher Kist
- The Center for Better Health and Nutrition; The Heart Institute; Cincinnati Children's Hospital Medical Center; Cincinnati OH USA
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Abstract
BACKGROUND Reduced motor performance can negatively affect physical activity and social partake after childhood cancer. Especially in bone tumor patients, who are at risk of physical limitations due to surgical interventions, motor performance has not yet been sufficiently investigated. Therefore, this study aimed at assessing motor performance in pediatric bone tumor patients. PROCEDURE Motor performance was measured within 2 years posttreatment using the MOON (test for MOtor performance in pediatric ONcology) test. This instrument enables quantitative data collection even in physically impaired patients for comparison with age-matched and sex-matched reference values. RESULTS Twenty-one patients (13 male) ages 15.2±2.1 years (median: 15 y, 10 to 19 y) and 9.4±7.4 months posttreatment (median: 6 mo, 2 to 24 mo) were tested. Motor performance was slightly reduced in muscular endurance of the legs; significantly reduced in speed, flexibility, eye-hand coordination, and muscular explosive strength (P<0.001), whereas patients' hand grip strength and static balance were superior to the reference values. Follow-up duration, body mass index, and tumor localization apparently affected motor performance. CONCLUSIONS These findings show serious reductions in motor performance within 2 years after bone tumor treatment and highlight the need for interventions to improve motor performance. The results should be used to advise and support patients to engage in suitable physical and sports activities.
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Berkman AM, Lakoski SG. Treatment, behavioral, and psychosocial components of cardiovascular disease risk among survivors of childhood and young adult cancer. J Am Heart Assoc 2015; 4:jah3923. [PMID: 25836057 PMCID: PMC4579959 DOI: 10.1161/jaha.115.001891] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Amy M Berkman
- Office of Health Promotion Research, University of Vermont, Burlington, VT (A.M.B.)
| | - Susan G Lakoski
- Department of Internal Medicine, University of Vermont, Burlington, VT (S.G.L.) Vermont Center on Behavior Health and Vermont Cancer Center, Burlington, VT (S.G.L.)
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Health-related quality of life in young survivors of childhood cancer. Qual Life Res 2015; 24:2151-61. [DOI: 10.1007/s11136-015-0961-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2015] [Indexed: 10/23/2022]
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Do patients with ewing's sarcoma continue with sports activities after limb salvage surgery of the lower extremity? Clin Orthop Relat Res 2015; 473:839-46. [PMID: 24748070 PMCID: PMC4317429 DOI: 10.1007/s11999-014-3622-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Limb salvage surgery has evolved to become the standard method of treating sarcomas of the extremities with acceptable oncologic results. However, little information exists relative to the activity level or ability to participate in sports after tumor reconstructions. QUESTIONS/PURPOSES The aims of the study were to answer the following questions: (1) Which sports activity levels and what types of sports can be expected in the long term after tumor reconstruction? (2) Which frequency durations are patients with Ewing's sarcoma able to perform in long-term followup after local control? (3) Do surgical complications affect sports activity level? METHODS Thirty patients (13 females, 17 males; mean age, 18 ± 8 years; range, 2-36 years at diagnosis; mean followup 16 ± 6 years [minimum, 5 years]) were included. Tumors were located in the pelvis, femur, tibia, and fibula. Surgical procedures included surgical resections alone (n = 8), surgical resection with biological reconstruction (n = 9), or endoprosthetic reconstruction (n = 13). We assessed UCLA sports activity levels, kinds of sports as well as the frequency per week and the duration of each training unit at long term (minimum followup, 5 years). RESULTS In long-term followup 83% patients (25 of 30) were performing athletic activity regularly. The hours/week of sports depended on type of surgery and were highest after resections in the pelvis and femur (5.8) and were lowest after megaprosthetic reconstruction of the pelvis (1.0). Patients undergoing biologic reconstructions were able to perform high-impact sports. UCLA sports activity levels were high after joint-preserving vascularized fibula for tibia reconstruction (7.4) and after megaprosthetic reconstruction of the lower extremity (6.3-6.4) and were low after tumors located in the fibula (4.2). Complications during followup did not significantly influence sports activity in long-term survivors. CONCLUSIONS Long-term survivors can achieve high levels of sports activity in many instances. Tumor sites are associated with the postoperative sports activity levels. This information can help surgeons counsel patients in terms of athletic expectations after limb salvage reconstruction for patients with Ewing's sarcoma. LEVEL OF EVIDENCE Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Effect of an Ankle Foot Orthosis Intervention for Children With Non-Central Nervous System Cancers: A Pilot Study. Pediatr Phys Ther 2015; 27:425-31. [PMID: 26397091 DOI: 10.1097/pep.0000000000000180] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Children with cancer are at risk for physical performance limitations. In this pilot study we investigated the feasibility and initial efficacy of an ankle foot orthosis (AFO) in children with non-central nervous system cancer with peripheral weakness. METHODS Participants included children aged 5 to 11 years diagnosed with cancer. Children wore AFOs for 1 cycle of chemotherapy. Pre- and postintervention adverse events, adherence, gait, strength, range of motion, activity, and fatigue were measured. RESULTS Six of 7 children completed the study; none of the 7 reported adverse events. Positive trends were observed in step length (46.23-49.25 cm), dorsiflexion strength (19.25-24.50 lb), ankle dorsiflexion range of motion (0.5-8°), and activity (7850-9857 epochs). Negative trends observed included cadence and fatigue ratings. No change was observed in the 6-minute walk or parent-reported fatigue. CONCLUSIONS An AFO intervention is feasible in children with cancer. Initial efficacy results warrant further study.
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Berbis J, Oudin C, Alessandrini M, Vercasson C, Barlogis V, Chambost H, Michel G, Auquier P. Quality of life in minor siblings of childhood leukemia survivors, long-term after diagnosis: A LEA study (for Leucemies de l'Enfant et de l'Adolescent-childhood and adolescent leukemia). Psychooncology 2014; 24:661-8. [DOI: 10.1002/pon.3709] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 09/19/2014] [Accepted: 09/25/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Julie Berbis
- Aix-Marseilles Univ, EA 3279 - Public Health; Chronic Diseases and Quality of Life - Research Unit; 13005 Marseilles France
| | - Claire Oudin
- Aix-Marseilles Univ; Department of Paediatric Haematology-Oncology, APHM; Marseilles France
| | - Marine Alessandrini
- Aix-Marseilles Univ, EA 3279 - Public Health; Chronic Diseases and Quality of Life - Research Unit; 13005 Marseilles France
| | - Camille Vercasson
- Aix-Marseilles Univ, EA 3279 - Public Health; Chronic Diseases and Quality of Life - Research Unit; 13005 Marseilles France
| | - Vincent Barlogis
- Aix-Marseilles Univ, EA 3279 - Public Health; Chronic Diseases and Quality of Life - Research Unit; 13005 Marseilles France
- Aix-Marseilles Univ; Department of Paediatric Haematology-Oncology, APHM; Marseilles France
| | - Hervé Chambost
- Aix-Marseilles Univ; Department of Paediatric Haematology-Oncology, APHM; Marseilles France
| | - Gérard Michel
- Aix-Marseilles Univ, EA 3279 - Public Health; Chronic Diseases and Quality of Life - Research Unit; 13005 Marseilles France
- Aix-Marseilles Univ; Department of Paediatric Haematology-Oncology, APHM; Marseilles France
| | - Pascal Auquier
- Aix-Marseilles Univ, EA 3279 - Public Health; Chronic Diseases and Quality of Life - Research Unit; 13005 Marseilles France
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Ozono S, Ishida Y, Honda M, Okamura J, Asami K, Maeda N, Sakamoto N, Inada H, Iwai T, Kamibeppu K, Kakee N, Horibe K. General Health Status and Late Effects Among Adolescent and Young Adult Survivors of Childhood Cancer in Japan. Jpn J Clin Oncol 2014; 44:932-40. [DOI: 10.1093/jjco/hyu102] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Smith WA, Li Z, Loftin M, Carlyle BE, Hudson MM, Robison LL, Ness KK. Measured versus self-reported physical function in adult survivors of childhood cancer. Med Sci Sports Exerc 2014; 46:211-8. [PMID: 23899895 PMCID: PMC4128913 DOI: 10.1249/mss.0b013e3182a65c73] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE Childhood cancer survivors (CCS) experience late effects that interfere with physical function. Limitations in physical function can affect CCS abilities to actively participate in daily activities. The purpose of this investigation was to evaluate the concordance between self-reported physical performance and clinically evaluated physical performance among adult CCS. METHODS CCS 18 yr or older and 10 yr or older from diagnosis who are participants in the St. Jude Lifetime cohort study responded to the physical function section of the Medical Outcome Survey Short Form (SF-36). Measured physical performance was evaluated using the Physical Performance Test and the 6-Minute Walk Test. RESULTS Individuals (N = 1778, 50.8% female) with a median time since diagnosis of 24.9 yr (range = 10.9-48.2) and a median age of 32.4 yr (range = 19.1-48.2) completed testing. Limitations in physical performance were self-reported by 14.1% of participants. The accuracy of self-report physical performance was 0.87 when the SF-36 was compared with the 6-Minute Walk Test or the Physical Performance Test. Reporting inaccuracies most often involved reporting a physical performance limitation. Poor accuracy was associated with previous diagnosis of a bone or CNS tumor, lymphoma, older age, and large body size. CONCLUSIONS These results suggest that self-report, using the physical performance subscale of the SF-36, correctly identifies CCS who do not have physical performance limitations. In contrast, this same measure is less able to identify individuals who have performance limitations.
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Affiliation(s)
- Webb A Smith
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
- Departments of Health, Exercise Science, and Recreation, University of Mississippi, University, MS
| | - Zhenghong Li
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Mark Loftin
- Departments of Health, Exercise Science, and Recreation, University of Mississippi, University, MS
| | - Brent E. Carlyle
- Department of Urology, The Ohio State University College of Medicine, Columbus, OH
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
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Rueegg CS, Gianinazzi ME, Michel G, von der Weid NX, Bergstraesser E, Kuehni CE. Do childhood cancer survivors with physical performance limitations reach healthy activity levels? Pediatr Blood Cancer 2013; 60:1714-20. [PMID: 23681516 DOI: 10.1002/pbc.24595] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 04/16/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND The extent to which physical performance limitations affect the ability of childhood cancer survivors to reach healthy activity levels is unknown. Therefore this study aims to describe the effect of different types of limitations on activity levels in survivors. PROCEDURE Within the Swiss Childhood Cancer Survivor Study we sent a questionnaire to all survivors (≥16 years) registered in the Swiss Childhood Cancer Registry, who survived >5 years and were diagnosed 1976-2005 aged <16 years. We measured healthy activity levels using international guidelines and assessed different kinds of performance limitations (visual impairment, weight and endurance problems, cardiorespiratory, musculoskeletal, and neurological problems, pain and fatigue syndromes). RESULTS The sample included 1,560 survivors (75% response rate), of whom 209 (13.5%) reported they have performance limitations. Forty-two percent of survivors with limitations reached healthy activity levels, compared to 57% of survivors without limitations. Least active were survivors with vision impairments (25% active), weight and endurance problems (27.3%), cardiorespiratory problems (36.4%), and musculoskeletal problems (43.1%). After adjusting for socio-demographic variables and type of cancer, we found that survivors with limitations were 1.4 (95%CI 1.0-2.0; P = 0.047) times more likely to be inactive. CONCLUSIONS Although many survivors with physical performance limitations maintain healthy activity levels, there is room for improvement. Adapted and targeted physical activity counseling for survivors with performance limitations might help them to raise level of activity and pursue a healthy lifestyle.
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Affiliation(s)
- Corina S Rueegg
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
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Rueegg CS, Gianinazzi ME, Rischewski J, Beck Popovic M, von der Weid NX, Michel G, Kuehni CE. Health-related quality of life in survivors of childhood cancer: the role of chronic health problems. J Cancer Surviv 2013; 7:511-22. [DOI: 10.1007/s11764-013-0288-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 04/12/2013] [Indexed: 11/30/2022]
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