72 research outputs found
Surveillance imaging for high-grade childhood brain tumors: What to do 10 years after completion of treatment?
No full textBrain tumors are the second most common childhood cancer. Treatment protocols for high-grade pediatric brain tumors recommend regular follow-up imaging for up to 10 years. We review maximal time to recurrence and minimal time to radiologically detectable long-term sequelae such as secondary malignancies, vascular complications, and white matter disease. No tumors recurred after the 10-year point, but radiological long-term sequelae grew more common as the treatment completion date receded. We do not recommend regular imaging more than 10 years after treatment has ended, unless there are clinical symptoms
Pulmonary disease, its risk factors and necessity for long-term follow-up care in childhood cancer survivors.
No full textTreatment for childhood cancer puts the young patients at risk to develop adverse health outcomes. These adverse health outcomes can develop acute, already during treatment, or slowly over years to decades after completion of treatment. They can be of transient nature or long-lasting and chronic. Adverse health outcomes can potentially affect every organ system, including the lung. The term late effects is used to describe this heterogeneity of adverse health outcomes. Pulmonary late effects contribute to a higher morbidity and mortality in childhood cancer survivors compared to siblings or the general population
Médecine intégrative en oncologie pédiatrique.
No full textThis article provides an overview of the integrative medicine approach in pediatric oncology that combines conventional medicine with complementary therapies. As a practice example, the division of pediatric oncology from the Children's Hospital St. Gallen describes their use and experience of two different methods of integrative medicine on a daily basis. However, this review article also shows the lack of studies dedicated to integrative medicine in pediatric oncology, particularly regarding efficacy and safety of the different applications
Aftercare of Childhood Cancer Survivors in Switzerland: Protocol for a Prospective Multicenter Observational Study.
No full textBACKGROUND
Most children and adolescents diagnosed with cancer become long-term survivors. For most of them, regular follow-up examinations to detect and treat late effects are necessary, especially in adulthood. The transition from pediatric to adult-focused follow-up care is a critical moment for childhood cancer survivors (CCSs); a substantial proportion of CCSs are lost to follow-up in this transition process and do not attend follow-up care in adulthood. This can have serious effects on survivors' health if late effects are not discovered in a timely fashion.
OBJECTIVE
In this study, we primarily assess the current follow-up situation, related needs, and knowledge of adolescent and young adult CCSs who have transitioned from pediatric to adult-focused follow-up care. As secondary objectives, we evaluate transition readiness, identify facilitating factors of transition and adherence to long-term follow-up (LTFU) care, and compare three different transition models.
METHODS
The Aftercare of Childhood Cancer Survivors (ACCS) Switzerland study is a prospective, multicenter, observational study that was approved by the ethics committee in February 2019. We are recruiting CCSs from three pediatric oncology centers and using questionnaires to answer the study questions.
RESULTS
To date, we have recruited 58 participants. The study is ongoing, and recruitment of participants will continue until January 2021.
CONCLUSIONS
The ACCS study will provide information on CCSs' preferences and expectations for follow-up care and their transition into the adult setting. The results will help improve the LTFU care and cancer knowledge of CCSs and subsequently enhance adherence to follow-up care and reduce loss to follow-up in adulthood.
TRIAL REGISTRATION
ClinicalTrials.gov NCT04284189; https://clinicaltrials.gov/ct2/show/NCT04284189?id=NCT04284189.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
PRR1-10.2196/18898
Transition from pediatric to adult follow-up care in childhood cancer survivors-a systematic review.
No full textPURPOSE
The successful transition of childhood cancer survivors from pediatric- to adult-focused long-term follow-up care is crucial and can be a critical period. Knowledge of current transition practices, especially regarding barriers and facilitators perceived by survivors and health care professionals, is important to develop sustainable transition processes and implement them into daily clinical practice. We performed a systematic review with the aim of assessing transition practices, readiness tools, and barriers and facilitators.
METHODS
We searched three databases (PubMed, Embase/Ovid, CINAHL) and included studies published between January 2000 and January 2020. We performed this review according to the PRISMA guidelines and registered the study protocol on PROSPERO; two reviewers independently extracted the content of the included studies.
RESULTS
We included 26 studies: six studies described current transition practices, six assessed transition readiness tools, and 15 assessed barriers and facilitators to transition.
CONCLUSION
The current literature describing transition practices is limited and overlooks adherence to follow-up care as a surrogate marker of transition success. However, the literature provides deep insight into barriers and facilitators to transition and theoretical considerations for the assessment of transition readiness. We showed that knowledge and education are key facilitators to transition that should be integrated into transition practices tailored to the individual needs of each survivor and the possibilities and limitations of each country's health care system.
IMPLICATIONS FOR CANCER SURVIVORS
The current knowledge on barriers and facilitators on transition should be implemented in clinical practice to support sustainable transition processes
Wie Schweizer Kinder, Jugendliche und junge Erwachsene eine stationäre onkologische Rehabilitation beurteilen.
No full textBACKGROUND
Inpatient rehabilitation improves physical and psychosocial performance in childhood cancer patients and their families. Two kinds of inpatient rehabilitation are available in specialized institutions in Germany: family-oriented rehabilitation or peer group-oriented rehabilitation for adolescents and young adults (AYA). Our study aimed to find out what Swiss childhood and AYA cancer patients and their families thought about the rehabilitation programs in which they had participated.
PATIENTS AND METHODS
We conducted a questionnaire-based, cross-sectional study of Swiss childhood and AYA cancer patients and their families whose inpatient rehabilitation stays were scheduled to take place in Germany between May 2012 and March 2019. We analyzed the data descriptively and present our findings in accordance with the STROBE statement.
RESULTS
Of the 57 eligible families contacted, 38 (67%) responded. Most rated the rehabilitation stay as very good (68%) or good (26%). Nearly all participants emphasized that these programs should be available to all affected patients and their families. Most (80%) thought the program gave them enough valuable information to enable them to cope with daily life after the stay ended. Only one fifth (19%) of the rehabilitation stays were fully funded by the health or disability insurance.
CONCLUSION
Participants expressed an overwhelmingly positive opinion about the rehabilitation programs they attended. We are convinced that childhood and AYA cancer patients and their families in Switzerland benefit from these programs and encourage insurances to cover the costs.Hintergrund
Spezialisierte stationäre Rehabilitation verbessert die physische und psychosoziale Gesundheit von Kinderkrebspatienten und deren Familien. In Deutschland gibt es 2 entsprechende Rehabilitationsformen: die Familien-orientierte Rehabilitation oder die Gruppenrehabilitation für Adoleszente und junge Erwachsene (AYA). Ziel dieser Studie ist es, dass Schweizer Kinderkrebspatienten und deren Familien ihren absolvierten Rehabilitationsaufenthalt bewerten.
Patienten und Methode
Diese fragebogenbasierte Querschnittsstudie schloss an Krebs erkrankte Kinder, AYA sowie deren Familien aus der Schweiz ein, die zwischen Mai 2012 und März 2019 an einer stationären Rehabilitation in Deutschland teilgenommen haben. Wir analysierten die Daten deskriptiv und stellen die Resultate gemäss den STROBE-Kriterien dar.
Ergebnisse
Wir kontaktierten 57 Familien, wovon 38 (67%) teilgenommen haben. Die meisten Teilnehmer beurteilten den Rehabilitationsaufenthalt als sehr gut (68%) oder gut (26%). Fast alle Teilnehmer betonten, dass solche Aufenthalte allen betroffenen Patienten und deren Familien zur Verfügung stehen sollten. Den meisten Teilnehmern (80%) wurden genügend und wertvolle Möglichkeiten aufgezeigt, den Alltag nach der Rehabilitation zu meistern. Nur jeder fünfte Rehabilitationsaufenthalt wurde komplett durch obligatorische Versicherungen bezahlt.
Schlussfolgerung
Die Teilnehmer haben eine durchwegs sehr positive Meinung über die onkologische stationäre Rehabilitation, die sie in Deutschland besucht haben. Wir sind überzeugt, dass Schweizer Kinder und AYA sowie deren Familien von diesen Rehabilitationsprogrammen profitieren und ermutigen die Versicherungen, die Kosten zu übernehmen
Determining transition readiness in Swiss childhood cancer survivors - a feasibility study.
No full textBACKGROUND
The successful transition of childhood cancer survivors (CCSs) from pediatric to adult long-term follow-up care is a critical phase, and determining the right time point can be challenging. We assessed the feasibility of the use of existing transition readiness tools in the context of the Swiss health care system, assessed partly transition readiness in Swiss CCSs, and compared our findings with Canadian CCSs for which these tools were originally developed.
METHODS
We officially translated the Cancer Worry Scale (CWS) and Self-Management Skill Scale (SMSS) into German and integrated them into this cross-sectional study. We included CCSs attending the long-term follow-up (LTFU) clinic in the Division of Oncology-Hematology, Department of Pediatrics, Kantonsspital Aarau. We used descriptive statistics to describe transition readiness.
RESULTS
We randomly recruited 50 CCSs aged ≥18 years at participation. The CCSs had a median CWS score of 62 (interquartile range 55-71), indicating a moderate level of cancer-related worry. Despite high self-management skills, some answers showed a dependency of CCSs on their parents. Our experience shows that the CWS and SMSS are easy for Swiss CCSs to use, understand, and complete. The interpretation of the results must take differences in health care systems between countries into account.
CONCLUSIONS
The translated CWS and SMSS are appropriate additional measures to assess transition readiness in CCSs. These scales can be used longitudinally to find the individual time point for transition and the completion by CCSs enables the health care team to individualize the transition process and to support the CCSs according to their individual needs
Cardiovascular and Pulmonary Challenges After Treatment of Childhood Cancer.
No full textChildhood cancer survivors are at risk for developing cardiovascular disease and pulmonary disease related to cancer treatment. This might not become apparent until many years after treatment and varies from subclinical to life-threatening disease. Important causes are anthracyclines and radiotherapy involving heart, head, or neck for cardiovascular disease, and bleomycin, busulfan, nitrosoureas, radiation to the chest, and lung or chest surgery for pulmonary disease. Most effects are dose dependent, but genetic risk factors have been discovered. Treatment options are limited. Prevention and regular screening are crucial. Survivors should be encouraged to adopt a healthy lifestyle, and modifiable risk factors should be addressed
Paediatric cohort studies on lower respiratory diseases and their reporting quality: systematic review of the year 2018.
No full textThe paediatric respiratory research community uses cohort studies extensively. However, the landscape of these studies and their quality of reporting has not been assessed.We performed a systematic review of publications on cohort studies reporting on paediatric lower respiratory problems published in 2018. We searched Medline and EMBASE and extracted data on the studies' and journals' characteristics. We assessed the number of items of the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist that a random sample (100 papers) reported. We analysed factors associated with the STROBE score and with the most poorly reported items, using Poisson and logistic regressionOf the 21 319 records identified, 369 full-text articles met our inclusion criteria. Most papers studied asthma aetiology through birth cohorts and were based in Europe or North America. The reporting quality was insufficient: 15% reported the 22 STROBE items; median score: 18 (IQR: 16-21). The most poorly reported items were: sources of bias, sample size, statistical methods, descriptive results and generalisability. None of the studies' or journals' factors were associated with the STROBE score.We need a joined effort of editors, reviewers and authors to improve the reporting quality of paediatric cohort studies on respiratory problems
Incidence and prevalence of musculoskeletal health conditions in survivors of childhood and adolescent cancers: A report from the Swiss childhood cancer survivor study.
No full textPURPOSE
Childhood cancer and its treatment can cause damage to the musculoskeletal system. We aimed to determine the incidence and prevalence of musculoskeletal health conditions (MSHC) in survivors, and to investigate differences by cancer-related characteristics.
METHODS
We used data from the Childhood Cancer Registry and the Swiss Childhood Cancer Survivor Study, including survivors (≥5 years since diagnosis; diagnosed 1976-2015 at <20 years of age) aged ≥15 years at study. Cumulative incidence and prevalence of MSHCs (osteoporosis, limb length discrepancy, limited joint mobility, bone/joint pain, scoliosis, changes to chest/ribs and amputation) were calculated from self-reported data.
RESULTS
We included 2645 survivors (53% men; median age 24 years, range 15-59 years). Prevalence and cumulative incidence of any MSHC was 21% and 26%, respectively. Incidence rate for any MSHC was 15.6/1000 person-years. Scoliosis (8%), bone/joint pain (7%) and limited joint mobility (7%) were the most prevalent MSHC. MSHC co-occurred with other health conditions in 87% of survivors. We found increased rates of MSHC in women (RR = 1.4, 95%CI: 1.2-1.7), bone tumour survivors (RR = 6.0, 95%CI: 4.5-7.9), survivors older at diagnosis (11-15 years: RR = 1.8, 95%CI: 1.5-2.3), after a relapse (RR = 1.5, 95%CI: 1.3-1.9), treatment with surgery (RR = 1.2, 95%CI: 1.0-1.5), chemotherapy (RR = 1.4, 95%CI: 1.1-1.8) or stem cell transplantation (RR = 1.6, 95%CI: 1.0-2.5), and more recent year of diagnosis (2011-2015: RR = 4.3, 95%CI: 2.8-6.8).
CONCLUSION
MSHCs are prevalent in survivors, the risk is increasing in younger survivor cohorts, and MSHCs usually occur in multimorbid survivors. Strengthening of rehabilitation services and appropriate referrals are needed to mitigate the effects of the cancer and cancer treatment
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