Long-term effects of cancer therapy in children – functional effects, late mortality and long-term follow-up

Skinner, Roderick

doi:10.1016/j.paed.2012.02.008

Cited by 9 publications

(4 citation statements)

References 9 publications

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“…25 Current follow-up guidelines for childhood cancer survivors in Great Britain suggest that survivors diagnosed with cancer and in particular those who received cranial irradiation, were treated at a young age and/or had a CNS neoplasm should have regular cognitive assessment and educational support should be offered as well as support for obtaining employment. 27,28 Guidelines in the United States recommend yearly psychosocial assessment with particular emphasis on following educational and vocational progress for all types of cancer diagnoses, although the highest risk is noted in CNS neoplasm survivors and those who had CNS directed treatment. 29 This study has provided evidence of factors associated with employment and occupational level such as epilepsy, hearing or vision problems which could be targeted in interventions and in follow-up clinics to help survivors achieve their full potential in gaining suitable employment.…”

Section: Discussionmentioning

confidence: 99%

Employment status and occupational level of adult survivors of childhood cancer in Great Britain: The British childhood cancer survivor study

Frobisher

Lancashire

Jenkinson

et al. 2017

Intl Journal of Cancer

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The British Childhood Cancer Survivor Study (BCCSS) provides the first detailed investigation of employment and occupation to be undertaken in a large population‐based cohort. Previous studies have been limited by design issues such as using small numbers of survivors with specific diagnoses, and involved limited assessment of employment status and occupational level. The BCCSS includes 17,981 5‐year survivors of childhood cancer. Employment status and occupational level were ascertained by questionnaire from eligible survivors (n = 14,836). Multivariate logistic regression was used to explore factors associated with employment and occupation, and to compare survivors to their demographic peers in the general population. Employment status was available for 10,257 survivors. Gender, current age, cancer type, radiotherapy, age at diagnosis and epilepsy were consistently associated with being: employed; unable to work; in managerial or non‐manual occupations. Overall, survivors were less likely to be working than expected (OR (99% CI): 0.89 (0.81–0.98)), and this deficit was greatest for irradiated CNS neoplasm survivors (0.34 (0.28–0.41)). Compared to the general population, survivors were fivefold more likely to be unable to work due to illness/disability; the excess was 15‐fold among CNS neoplasm survivors treated with radiotherapy. Overall survivors were less likely to be in managerial occupations than expected (0.85 (0.77–0.94)). However, bone sarcoma survivors were more likely to be in these occupations than expected (1.37 (1.01–1.85)) and also similarly for non‐manual occupations (1.90 (1.37–2.62)). Survivors of retinoblastoma (1.55 (1.20–2.01)) and ‘other’ neoplasm group (1.62 (1.30–2.03)) were also more likely to be in non‐manual occupations than expected.

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Section: Discussionmentioning

confidence: 99%

Employment status and occupational level of adult survivors of childhood cancer in Great Britain: The British childhood cancer survivor study

Frobisher

Lancashire

Jenkinson

et al. 2017

Intl Journal of Cancer

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“…Although the mechanisms underlying the observed muscle dysfunction are not clear, it is likely that chemotherapy treatments have an important direct role. The growing awareness of the late effects of cancer and cancer treatments has stimulated calls to establish long-term surveillance for the survivors of pediatric cancers (Aslett et al, 2007; Oeffinger et al, 2010; Prasad et al, 2010; Skinner, 2012b). If successful such programs will allow more systematic identification and characterization of affected individuals, and will hopefully facilitate studies to investigate the hypotheses proposed here and to initiate potential intervention studies.…”

Section: The Broader Implications Of Long-term Chemotherapy-induced Smentioning

confidence: 99%

After the chemotherapy: potential mechanisms for chemotherapy-induced delayed skeletal muscle dysfunction in survivors of acute lymphoblastic leukaemia in childhood

Scheede‐Bergdahl

Jagoe

2013

Front. Pharmacol.

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There is evidence that survivors of childhood cancers, such as acute lymphoblastic leukemia (ALL), have increased rates of long-term skeletal muscle dysfunction. This places them at higher risk of physical restriction and functional impairment as well as potentially contributing to observed increases in cardiovascular disease and insulin resistance in later life. The mechanisms underlying these changes in skeletal muscle are unknown but chemotherapy drugs used in treatment for ALL are strongly implicated. Normal skeletal muscle growth, development, and function are dependent on correctly functioning muscle satellite cells, muscle motor neurons, and muscle mitochondria. Each of these key components is potentially susceptible to damage by chemotherapy in childhood, particularly prolonged courses including repeated administration of combination chemotherapy. If this chemotherapy-induced damage is not fully reversible, impairment of satellite cells, muscle motor innervation, and mitochondria could, either singly or together, lead to the emergence of delayed or persistent skeletal muscle dysfunction many years later. The known effects of individual drugs used in the treatment of ALL are outlined and the need for specific targeted studies to investigate the mechanisms underlying persistent muscle dysfunction in survivors of ALL and other childhood cancers is highlighted.

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“…La literatura, actualmente, respalda la prehabilitación, ya que se han observado mejores outcomes cuando se inician programas muy tempranamente 13 .…”

Section: Generalidades De La Población Estudiadaunclassified

Perfil clínico-funcional de niños que ingresan a un programa de rehabilitación oncológica en una ONG chilena

Ormeño

Vargas²,

Ormeño

et al. 2020

Rehabil. integral.

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Introducción: Los pacientes oncológicos infantiles presentan diversas deficiencias en sus funciones y estructuras corporales derivados de los tumores mismos o de los distintos tratamientos empleados, ya sea cirugía, quimioterapia, radioterapia o la suma de ellos. Estas deficiencias generan gran discapacidad en todas las áreas del funcionamiento. Objetivo: Des-cribir el perfil clínico y funcional de niños que ingresan a un programa de rehabilitación oncológica. Materiales y Métodos: Estudio observacional, restrospectivo y descriptivo. Se revisaron 109 fichas clínicas de pacientes ingresados al programa de rehabilitación oncológica de Fundación Nuestros Hijos entre los años 2014 y 2017, que cumplieron criterios de ingreso. Se obtuvieron los datos de la evaluación clínica realizada por médico fisiatra y pruebas funcionales al ingreso, incluyendo Timed Up and Go Test, Pediatric Balance Scale y test de Marcha de 6 min. Resultados: El promedio de edad fue de 8,7 ± 3,4 años. Los diagnósticos más frecuentes fueron tumores de sistema nervioso central (50,4%), leucemias y linfomas (24,4%). Un 53,2% de los pacientes se encontraba en tratamiento activo al momento del ingreso. El déficit motor fue el más frecuente (79,8%). Dentro de este grupo, 19 niños (17,4%) presentaron hemiparesia y 18 niños (16,5%) tetraparesia. Del total, 44% reportó presencia de fatiga, 28,4% presentó trastorno de la deglución, 34,9% trastorno visual y un 56,9% compromiso cognitivo. Conclusiones: Los niños que ingresan a rehabilitación oncológica presentan múltiples defi-ciencias en diversas áreas de su funcionamiento, tanto en etapas tempranas como tardías de su tratamiento. El compromiso, motor, deglutorio, visual y cognitivo son las deficiencias más frecuentes de encontrar, sobre todo en pacientes con tumores de SNC.

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Long-term effects of cancer therapy in children – functional effects, late mortality and long-term follow-up

Cited by 9 publications

References 9 publications

Employment status and occupational level of adult survivors of childhood cancer in Great Britain: The British childhood cancer survivor study

Employment status and occupational level of adult survivors of childhood cancer in Great Britain: The British childhood cancer survivor study

After the chemotherapy: potential mechanisms for chemotherapy-induced delayed skeletal muscle dysfunction in survivors of acute lymphoblastic leukaemia in childhood

Perfil clínico-funcional de niños que ingresan a un programa de rehabilitación oncológica en una ONG chilena

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