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Peng L, Xiong SS, Li J, Wang M, Wong FKY. Promoting psychological support services for parents of children with sarcoma through health-social partnership: A quality improvement project. J Pediatr Nurs 2024; 77:e583-e592. [PMID: 38796359 DOI: 10.1016/j.pedn.2024.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 05/19/2024] [Accepted: 05/19/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE A significant portion of parents of children diagnosed with sarcoma experience excessive stress and anxiety disorder. This quality improvement project aimed to implement a psychological support service program tailored for parents of children with sarcoma and evaluate its effects. DESIGN AND METHODS An interprofessional team was formed through a health-social partnership to deliver comprehensive psychological support service program involving multiple cognitive-behavioral components to parents of children with sarcoma. Parents who were identified as having excessive stress and/or anxiety disorder and voluntarily agreed to participate were enrolled. Pre- and post-intervention assessments were conducted, and previously recorded data from parents of children hospitalized in the year prior to this quality improvement project were included as historical controls. RESULTS A total of 48 parents, including 35 mothers and 13 fathers, participated in the quality improvement project. Results showed that participants achieved greater reduction in emotional, somatic, and behavioral stress when compared with historical controls (all p < .001). Significantly lower prevalence of moderate to severe anxiety disorder was also found (4.2% vs. 85.4%, p < .001). CONCLUSIONS The implementation of a psychological support service program, informed by cognitive-behavioral theory and delivered through a health-social partnership, effectively alleviated multiple facets of stress and anxiety disorder in parents of children newly diagnosed with sarcoma. PRACTICE IMPLICATIONS Nurses can facilitate and coordinate the collaboration among interprofessional team to deliver specialized psychological support services and ensure that parents of children with sarcoma have access to these services, ultimately enhancing their psychological well-being.
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Affiliation(s)
- Li Peng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Sha-Sha Xiong
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Juan Li
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Mian Wang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; Joint Research Centre for Primary Health Care, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Frances Kam Yuet Wong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; Joint Research Centre for Primary Health Care, The Hong Kong Polytechnic University, Hong Kong, China
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Holthuis EI, Heins MJ, van Houdt WJ, Haas RL, Overbeek JA, Olde Hartman TC, Uijen AA, Wee L, van der Graaf WTA, Husson O. Improving Diagnosis and Care for Patients With Sarcoma: Do Real-World General Practitioners Data and Prospective Data Collections Have a Place Next to Clinical Trials? JCO Clin Cancer Inform 2024; 8:e2400054. [PMID: 38950319 DOI: 10.1200/cci.24.00054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/16/2024] [Accepted: 05/10/2024] [Indexed: 07/03/2024] Open
Abstract
There has been growing interest in the use of real-world data (RWD) to address clinically and policy-relevant (research) questions that cannot be answered with data from randomized controlled trials (RCTs) alone. This is, for example, the case in rare malignancies such as sarcomas as limited patient numbers pose challenges in conducting RCTs within feasible timeliness, a manageable number of collaborators, and statistical power. This narrative review explores the potential of RWD to generate real-world evidence (RWE) in sarcoma research, elucidating its application across different phases of the patient journey, from prediagnosis to the follow-up/survivorship phase. For instance, examining electronic health records (EHRs) from general practitioners (GPs) enables the exploration of consultation frequency and presenting symptoms in primary care before a sarcoma diagnosis. In addition, alternative study designs that integrate RWD with well-designed observational RCTs may offer relevant information on the effectiveness of clinical treatments. As, especially in cases of ultrarare sarcomas, it can be an extreme challenge to perform well-powered randomized prospective studies. Therefore, it is crucial to support the adaptation of novel study designs. Regarding the follow-up/survivorship phase, examining EHR from primary and secondary care can provide valuable insights into identifying the short- and long-term effects of treatment over an extended follow-up period. The utilization of RWD also comes with several challenges, including issues related to data quality and privacy, as described in this study. Notwithstanding these challenges, this study underscores the potential of RWD to bridge, at least partially, gaps between evidence and practice and holds promise in contributing to the improvement of sarcoma care.
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Affiliation(s)
- Emily I Holthuis
- Medical Oncology Department, NKI-AVL-Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Marianne J Heins
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | - Winan J van Houdt
- Surgical Oncology Department, NKI-AVL-Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Rick L Haas
- Department of Radiotherapy, NKI-AVL-Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Jetty A Overbeek
- PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands
| | - Tim C Olde Hartman
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute of Medical Innovation, Nijmegen, the Netherlands
| | - Annemarie A Uijen
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute of Medical Innovation, Nijmegen, the Netherlands
| | - Leonard Wee
- School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, the Netherlands
| | - Winette T A van der Graaf
- Medical Oncology Department, NKI-AVL-Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Olga Husson
- Medical Oncology Department, NKI-AVL-Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
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Wu X, Zhang W, Liu A, Zhang M. Factors associated with reproductive concerns among young female patients with colorectal cancer: A cross-sectional study. J Clin Nurs 2023. [PMID: 37127929 DOI: 10.1111/jocn.16736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 03/04/2023] [Accepted: 04/05/2023] [Indexed: 05/03/2023]
Abstract
AIMS AND OBJECTIVES The aim of this study was to describe the prevalence of reproductive concerns among young female patients with colorectal cancer and explore the associated factors. BACKGROUND With the trend of longer survival and younger age at diagnosis of colorectal cancer patients, reproductive concerns have become increasingly prevalent among young female colorectal cancer patients. DESIGN Cross-sectional design. METHODS The study included 150 young female patients with colorectal cancer who completed cancer treatment at 2 hospitals in Guangzhou, China, between November 2020 and December 2021 completed an investigation comprising A general questionnaire, The Reproductive Concerns After Cancer scale, The Family Adaptation and Cohesion Evaluation Scale II and unmet fertility information needs questionnaire. Multivariable linear regression analysis was performed in order to identify factors that influence reproductive concerns. This study was prepared and is reported according to the STROBE checklist. RESULTS The mean (SD) score on the Reproductive Concerns After Cancer scale was 54.78 ± 8.97. The highest score was for the children's health subscale (3.84 ± .92) and the lowest was for acceptance (2.24 ± .70). Multiple regression analysis showed that patients with fewer children, female children, lower education level (less than undergraduate degree), earlier disease stage, lower family function and higher unmet need for fertility information had more reproductive concerns, which explained 26.9% of the total variation of the model. CONCLUSIONS The patients with fewer children, female children, low cultural degree (less than bachelor), early clinical patients, poorer family function and higher unmet fertility information needs had higher reproductive concerns. RELEVANCE TO CLINICAL PRACTICE These findings can guide the development of interventions to mitigate reproductive concerns, including understand and meet their fertility information needs, improve the level of family function. PATIENT OR PUBLIC CONTRIBUTION Survey questionnaires were completed by participants among young female with colorectal cancer in this study.
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Affiliation(s)
- Xiaoyu Wu
- Clinical Nursing Teaching and Research Section, The Second XiangYa Hospital of Central South University, Changsha, China
| | - Wenxia Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Aihong Liu
- Department of Nursing, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Meifen Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Flatt SB, Baillargeon A, McClintock C, Pudwell J, Velez MP. Premature ovarian insufficiency in female adolescent and young adult survivors of non-gynecological cancers: a population-based cohort study. Reprod Health 2023; 20:4. [PMID: 36593491 PMCID: PMC9808928 DOI: 10.1186/s12978-022-01559-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The risk of premature ovarian insufficiency (POI) is increased in adolescent and young adult (AYA) cancer survivors, with the prevalence depending on cancer diagnosis, treatment, and patient factors. Prior studies are limited by sample size and type of cancer included. The objective of this study was to assess the risk of POI in female AYA survivors of non-gynecologic cancers, using a population-based approach. METHODS This population-based retrospective cohort study comprises 21,666 females, 15-39 years old, diagnosed with a single non-gynecologic cancer in Ontario, Canada from 1995 to 2015. Through health administrative data linkage, participants were followed until their 40th birthday, December 31, 2018, bilateral oophorectomy, loss of health insurance eligibility or death. Each cancer survivor was matched to 5 females who were not diagnosed with cancer (unexposed, n = 108,330). Women with bilateral oophorectomy or a prior menopause diagnosis were excluded. POI was identified through use of the ICD-9 code for menopause (ICD9-627). Modified Poisson regression models were used to calculate the adjusted relative risk (aRR) of POI for AYA cancer survivors compared to unexposed individuals, adjusted for income, parity, age, and immigration status. RESULTS The occurrence of POI was higher in survivors of AYA cancer versus unexposed patients (5.4% vs. 2.2%). Survivors of AYA cancer had an increased risk of POI relative to unexposed patients (aRR 2.49; 95% CI 2.32-2.67). Risk varied by type of cancer: breast (4.32; 3.84-4.86), non-Hodgkin's lymphoma (3.77; 2.88-4.94), Hodgkin's lymphoma (2.37; 1.91-2.96), leukemia (14.64; 10.50-20.42), thyroid (1.26; 1.09-1.46) and melanoma (1.04; 0.82-1.32). Risk varied by age at time of cancer diagnosis, with a higher risk among females diagnosed at age 30-39 years (3.07; 2.80-3.35) than aged 15-29 years (1.75; 1.55-1.98). CONCLUSIONS AYA survivors of non-gynecologic cancers are at an increased risk of POI, particularly survivors of lymphomas, leukemia, breast, and thyroid cancer. The risk of POI is increased for those diagnosed with cancer at an older age. These results should inform reproductive counseling of female AYAs diagnosed with cancer.
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Affiliation(s)
- Sydney B. Flatt
- grid.410356.50000 0004 1936 8331School of Medicine, Queen’s University, 15 Arch St., Kingston, ON K7L 3L4 Canada ,grid.410356.50000 0004 1936 8331Department of Obstetrics and Gynecology, Queen’s University, 76 Stuart St., Victory 4, Kingston, ON K7L 2V7 Canada
| | - Amanda Baillargeon
- grid.410356.50000 0004 1936 8331Department of Obstetrics and Gynecology, Queen’s University, 76 Stuart St., Victory 4, Kingston, ON K7L 2V7 Canada
| | | | - Jessica Pudwell
- grid.410356.50000 0004 1936 8331Department of Obstetrics and Gynecology, Queen’s University, 76 Stuart St., Victory 4, Kingston, ON K7L 2V7 Canada
| | - Maria P. Velez
- grid.410356.50000 0004 1936 8331Department of Obstetrics and Gynecology, Queen’s University, 76 Stuart St., Victory 4, Kingston, ON K7L 2V7 Canada ,ICES Queen’s, 21 Arch St, Kingston, ON K7L 2V7 Canada
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Zahnreich S, Schmidberger H. Childhood Cancer: Occurrence, Treatment and Risk of Second Primary Malignancies. Cancers (Basel) 2021; 13:cancers13112607. [PMID: 34073340 PMCID: PMC8198981 DOI: 10.3390/cancers13112607] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 12/14/2022] Open
Abstract
Cancer represents the leading cause of disease-related death and treatment-associated morbidity in children with an increasing trend in recent decades worldwide. Nevertheless, the 5-year survival of childhood cancer patients has been raised impressively to more than 80% during the past decades, primarily attributed to improved diagnostic technologies and multiagent cytotoxic regimens. This strong benefit of more efficient tumor control and prolonged survival is compromised by an increased risk of adverse and fatal late sequelae. Long-term survivors of pediatric tumors are at the utmost risk for non-carcinogenic late effects such as cardiomyopathies, neurotoxicity, or pneumopathies, as well as the development of secondary primary malignancies as the most detrimental consequence of genotoxic chemo- and radiotherapy. Promising approaches to reducing the risk of adverse late effects in childhood cancer survivors include high precision irradiation techniques like proton radiotherapy or non-genotoxic targeted therapies and immune-based treatments. However, to date, these therapies are rarely used to treat pediatric cancer patients and survival rates, as well as incidences of late effects, have changed little over the past two decades in this population. Here we provide an overview of the epidemiology and etiology of childhood cancers, current developments for their treatment, and therapy-related adverse late health consequences with a special focus on second primary malignancies.
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Pediatric sarcoma survivorship: A call for a developmental cascades approach. Dev Psychopathol 2021; 34:1221-1230. [PMID: 33851573 DOI: 10.1017/s095457942100002x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Survivors of pediatric sarcomas often experience greater psychological and psychosocial difficulties than their non-afflicted peers. We consider findings related to poorer outcomes from a developmental cascade perspective. Specifically, we discuss how physical, neurocognitive, psychological, and psychosocial costs associated with pediatric sarcomas and their treatment function transactionally to degrade well-being in long-term pediatric sarcoma survivors. We situate the sarcoma experience as a broad developmental threat - one stemming from both the presence and treatment of a life-imperiling disease, and the absence of typical childhood experiences. Ways in which degradation in one developmental domain spills over and effects other domains are highlighted. We argue that the aggregate effect of these cascades is two-fold: first, it adds to the typical stress involved in meeting developmental milestones and navigating developmental transitions; and second, it deprives survivors of crucial coping strategies that mitigate these stressors. This position suggests specific moments of intervention and raises specific hypotheses for investigators to explore.
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Kollár A, Müller S, Limacher A, Briner I, Klenke F, Bernhard J. Return to Work and Quality of Life in Disease-Free Adult Patients with Soft-Tissue and Bone Sarcoma of the Extremity. PRAXIS 2021; 110:22-29. [PMID: 33406937 DOI: 10.1024/1661-8157/a003592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Treatment of extremital sarcoma patients may be associated with significant functional disabilities and psychosocial distress affecting return to work (RtW) and quality of life (QoL). In this exploratory study we prospectively investigated the RtW rate, explored biomedical and psychosocial predictors of RtW, and compared generic QoL with Swiss population norms. Forty people (89 %) returned to work. Full-time employment before sarcoma diagnosis, high educational level, and low tumor grade showed an increased probability of RtW. The median age was lower in patients who returned to work, and they reported less fear of progression. Generic QoL (SF-36) was reduced in almost all dimensions when compared to a normative Swiss population. Physical functioning and fear of progression have to be addressed in the rehabilitation process.
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Affiliation(s)
- Attila Kollár
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Sabrina Müller
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | | | - Irene Briner
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Frank Klenke
- Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Jürg Bernhard
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland
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Chemoradiation impairs myofiber hypertrophic growth in a pediatric tumor model. Sci Rep 2020; 10:19501. [PMID: 33177579 PMCID: PMC7659015 DOI: 10.1038/s41598-020-75913-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 10/19/2020] [Indexed: 01/05/2023] Open
Abstract
Pediatric cancer treatment often involves chemotherapy and radiation, where off-target effects can include skeletal muscle decline. The effect of such treatments on juvenile skeletal muscle growth has yet to be investigated. We employed a small animal irradiator to administer fractionated hindlimb irradiation to juvenile mice bearing implanted rhabdomyosarcoma (RMS) tumors. Hindlimb-targeted irradiation (3 × 8.2 Gy) of 4-week-old mice successfully eliminated RMS tumors implanted one week prior. After establishment of this preclinical model, a cohort of tumor-bearing mice were injected with the chemotherapeutic drug, vincristine, alone or in combination with fractionated irradiation (5 × 4.8 Gy). Single myofiber analysis of fast-contracting extensor digitorum longus (EDL) and slow-contracting soleus (SOL) muscles was conducted 3 weeks post-treatment. Although a reduction in myofiber size was apparent, EDL and SOL myonuclear number were differentially affected by juvenile irradiation and/or vincristine treatment. In contrast, a decrease in myonuclear domain (myofiber volume/myonucleus) was observed regardless of muscle or treatment. Thus, inhibition of myofiber hypertrophic growth is a consistent feature of pediatric cancer treatment.
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Can mesenchymal stem cells ameliorate testicular damage? Current researches. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.770063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hompland I, Fauske L, Lorem GF, Bruland ØS. Use of a simple form to facilitate communication on long-term consequences of treatment in sarcoma survivors. Clin Sarcoma Res 2020; 10:2. [PMID: 31969978 PMCID: PMC6964017 DOI: 10.1186/s13569-019-0124-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/16/2019] [Indexed: 11/10/2022] Open
Abstract
Background To report on our experience using a simple optional form to facilitate communication on late effects between the patients and the oncologists during outpatient follow-up and to detail on the spectrum of challenges reported by sarcoma survivors. Methods The form was presented for the patients to complete before their consultation and covered topics related to late effects and unmet needs that the patient wished to discuss with the medical personnel. Logistic regression analysis examined how the distribution of the topics varied with age, gender, diagnosis and type of treatment received. Results The form was manageable in a busy outpatient clinic. Of the 265 patients that received the form, 236 (89%) returned it. Patients in a palliative setting and those with other diagnosis than bone sarcoma (BS) and soft-tissue sarcoma (STS) were excluded for subsequent analyses. The final study-cohort comprised 160 patients, 54 (34%) with BS and 106 (66%) with STS. Among these, 140 (88%) had late-effect topics they wanted to discuss with their oncologist. Fatigue was raised by 39% of the patients, pain by 29% and impaired mobility by 23%. BS patients raised fatigue more often (P < 0.005) than those with STS. Patients who had undergone multimodal treatment with chemotherapy raised fatigue more frequently (P < 0.001) than those who had only undergone surgery, radiotherapy or both. Conclusions A simple form on the long-term consequences of sarcoma treatment achieved a high response rate, was feasible to use in an outpatient clinic and facilitated communication on these issues. Fatigue was the most frequent topic raised and it was raised significantly more often in patients who had undergone chemotherapy.
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Affiliation(s)
- Ivar Hompland
- 1Department of Oncology, Norwegian Radium Hospital, Oslo University Hospital, Nydalen, P.O. Box 4953, Oslo, 0424 Norway
| | - Lena Fauske
- 1Department of Oncology, Norwegian Radium Hospital, Oslo University Hospital, Nydalen, P.O. Box 4953, Oslo, 0424 Norway.,2Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Geir Fagerjord Lorem
- 3Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Øyvind S Bruland
- 1Department of Oncology, Norwegian Radium Hospital, Oslo University Hospital, Nydalen, P.O. Box 4953, Oslo, 0424 Norway.,4Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Gargus E, Deans R, Anazodo A, Woodruff TK. Management of Primary Ovarian Insufficiency Symptoms in Survivors of Childhood and Adolescent Cancer. J Natl Compr Canc Netw 2019; 16:1137-1149. [PMID: 30181423 DOI: 10.6004/jnccn.2018.7023] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 03/12/2018] [Indexed: 12/18/2022]
Abstract
Cancer treatments can damage the ovaries, causing primary ovarian insufficiency (POI), a condition associated with numerous sequelae that impact long-term quality of life. This article systematically reviews the literature on the prevalence, surveillance, and treatment of POI in survivors of pediatric and adolescent and young adult (AYA) cancers. A systematic review of the literature was conducted in January 2018 through a search of Medline, Embase, Web of Science, and SCOPUS, alongside the screening of relevant reference lists. An initial search identified 746 potentially relevant studies. A total of 36 studies were included in the final review. Studies were categorized into one of the following categories: incidence/prevalence of POI, measurement of ovarian reserve, and other. Depending on patient characteristics, cancer diagnosis, and treatment, the prevalence of POI ranged from 2.1% to 82.2%. Risk factors for POI included exposure to alkylating agents and abdominal/pelvic radiation. POI may be associated with a number of complications, including low bone mineral density and poor cardiovascular health. Radiotherapy and chemotherapy are known to cause gonadal damage in female survivors of pediatric and AYA cancers. Acute or chronic effects depend on the dose of treatment, age of the individual, radiotherapy field, and ovarian reserve of the individual. Some women experience short-term loss of reproductive function and then may resume menstrual cycles, months or even years later. Although protecting fertility through banking of mature eggs, embryos, and tissue samples has become standard of care, additional steps need to be taken to ensure that patients have adequate hormone levels to maintain whole-body health, including life expectancy, bone health, cardiovascular health, quality of life, sexual and genitourinary function, and neurologic function. Surveillance and management of each of these comorbidities is critically important to survivor health.
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Logan S, Anazodo A. The psychological importance of fertility preservation counseling and support for cancer patients. Acta Obstet Gynecol Scand 2019; 98:583-597. [DOI: 10.1111/aogs.13562] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 01/29/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Shanna Logan
- School of Women and Children's Health Faculty of Medicine University of New South Wales – Sydney Kensington NSW Australia
- Kids Cancer Center Sydney Children's Hospital Randwick NSW Australia
- Fertility& Research Center Royal Hospital for Women Randwick NSW Australia
| | - Antoinette Anazodo
- School of Women and Children's Health Faculty of Medicine University of New South Wales – Sydney Kensington NSW Australia
- Kids Cancer Center Sydney Children's Hospital Randwick NSW Australia
- Nelune Comprehensive Cancer Center Prince of Wales Hospital Randwick NSW Australia
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Interventions to improve the aftercare of survivors of childhood cancer: A systematic review. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2018. [DOI: 10.1016/j.phoj.2018.11.186] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Gerber LH, Hodsdon B, Comis LE, Chan L, Gallin JI, McGarvey CL. A Brief Historical Perspective of Cancer Rehabilitation and Contributions From the National Institutes of Health. PM R 2018; 9:S297-S304. [PMID: 28942904 DOI: 10.1016/j.pmrj.2017.07.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/25/2017] [Accepted: 07/26/2017] [Indexed: 11/17/2022]
Abstract
People who have cancer diagnoses often need care throughout their lives through all stages of their illness. These stages include diagnosis, primary treatment, survivorship, and end of life. The management of people with cancer, now a common and chronic illness with long-term survival improving, is complex, challenging, and rapidly changing. Rehabilitation for people with cancer diagnoses is a new specialty and is charged with providing care throughout the trajectory of illness and wellness to maximize potential for function and mitigate disability. Rehabilitation interventions include the application of physical and occupational therapeutics, speech and language interventions, and physical medicine in order to help patients reach their individual goals and to promote life satisfaction. The Department of Rehabilitation in the Clinical Center of the National Institutes of Health has pioneered this field through research and clinical care models over the past 40 years. Staff of this department has supported clinical research investigators at the National Institutes of Health in their exploration of new treatments using chemotherapies, surgery, radiation, and psychosocial interventions. They have also engaged in research specific to rehabilitation to devise and improve functional outcome measures, design exercise interventions, devise orthotics, and prosthetic devices for adaptation to functional loss. Collectively, the staff has published widely in oncology textbooks and professional journals in order to share findings and improve the quality of cancer rehabilitation treatment across the continuum of care.
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Affiliation(s)
- Lynn H Gerber
- Department of Medicine, Inova Fairfax Medical Campus, Inova Health System, Fairfax, VA; 4400 University Dr., MS 2G7, George Mason University, Fairfax, VA 22030(∗).
| | - Bonnie Hodsdon
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD(†)
| | - Leora Ellen Comis
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD(‡)
| | - Leighton Chan
- Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD(§)
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Brunet J, Wurz A, Shallwani SM. A scoping review of studies exploring physical activity among adolescents and young adults diagnosed with cancer. Psychooncology 2018; 27:1875-1888. [PMID: 29719077 DOI: 10.1002/pon.4743] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 04/05/2018] [Accepted: 04/09/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Physical activity can improve health, functional capacity, and quality of life among children and adults diagnosed with cancer. Physical activity may also offer important benefits to adolescents and young adults diagnosed with cancer (AYAs). We conducted a scoping review to: determine the extent, range, and nature of published studies on physical activity among AYAs; identify knowledge gaps; and provide directions for future research. METHODS We searched 4 electronic databases for published studies. Two authors independently scanned the titles, abstracts, and full-texts against inclusion criteria: original research with humans, published in an English-language peer-reviewed journal, ≥50% of participants were diagnosed with cancer between the ages of 15 and 39 years, and included at least 1 measure of physical activity behavior. Data were extracted from studies meeting these criteria and subsequently summarized narratively. RESULTS Our search yielded 4729 articles; 32 met inclusion criteria. These included 18 cross-sectional and 4 longitudinal studies that explored descriptive (ie, sociodemographic or medical), physical, personal/psychological, social, other health behaviors, and/or other factors as antecedents or correlates of physical activity. The remaining 10 were intervention studies that focused on changing physical activity behavior or on testing the effects of physical activity. CONCLUSIONS We can conclude that physical activity is not well researched among AYAs. More high-quality research adopting longitudinal or intervention study designs that incorporate a range of descriptive, physical, personal/psychological, social, and environmental measures are warranted to better inform the development of behavior change interventions as well as to establish the benefits of physical activity for AYAs.
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Affiliation(s)
- Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.,Institut du savoir Montfort, Hôpital Montfort, Ottawa, Ontario, Canada.,Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Amanda Wurz
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Shirin M Shallwani
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Klosky JL, Wang F, Russell KM, Zhang H, Flynn JS, Huang L, Wasilewski-Masker K, Landier W, Leonard M, Albritton KH, Gupta AA, Casillas J, Colte P, Kutteh WH, Schover LR. Prevalence and Predictors of Sperm Banking in Adolescents Newly Diagnosed With Cancer: Examination of Adolescent, Parent, and Provider Factors Influencing Fertility Preservation Outcomes. J Clin Oncol 2017; 35:3830-3836. [PMID: 28976795 PMCID: PMC5707206 DOI: 10.1200/jco.2016.70.4767] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Purpose To estimate the prevalence of sperm banking among adolescent males newly diagnosed with cancer and to identify factors associated with banking outcomes. Patients and Methods A prospective, single-group, observational study design was used to test the contribution of sociodemographic, medical, psychological/health belief, communication, and developmental factors to fertility preservation outcomes. At-risk adolescent males (N = 146; age 13.00 to 21.99 years; Tanner stage ≥ 3), their parents, and medical providers from eight leading pediatric oncology centers across the United States and Canada completed self-report questionnaires within 1 week of treatment initiation. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% CIs for specified banking outcomes (collection attempt v no attempt and successful completion of banking v no banking). Results Among adolescents (mean age, 16.49 years; standard deviation, 2.02 years), 53.4% (78 of 146) made a collection attempt, with 43.8% (64 of 146) successfully banking sperm (82.1% of attempters). The overall attempt model revealed adolescent consultation with a fertility specialist (OR, 29.96; 95% CI, 2.48 to 361.41; P = .007), parent recommendation to bank (OR, 12.30; 95% CI, 2.01 to 75.94; P = .007), and higher Tanner stage (OR, 5.42; 95% CI, 1.75 to 16.78; P = .003) were associated with an increased likelihood of a collection attempt. Adolescent history of masturbation (OR, 5.99; 95% CI, 1.25 to 28.50; P = .025), banking self-efficacy (OR, 1.23; 95% CI, 1.05 to 1.45; P = .012), and parent (OR, 4.62; 95% CI, 1.46 to 14.73; P = .010) or medical team (OR, 4.26; 95% CI, 1.45 to 12.43; P = .008) recommendation to bank were associated with increased likelihood of sperm banking completion. Conclusion Although findings suggest that banking is underutilized, modifiable adolescent, parent, and provider factors associated with banking outcomes were identified and should be targeted in future intervention efforts.
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Affiliation(s)
- James L. Klosky
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - Fang Wang
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - Kathryn M. Russell
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - Hui Zhang
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - Jessica S. Flynn
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - Lu Huang
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - Karen Wasilewski-Masker
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - Wendy Landier
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - Marcia Leonard
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - Karen H. Albritton
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - Abha A. Gupta
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - Jacqueline Casillas
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - Paul Colte
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - William H. Kutteh
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
| | - Leslie R. Schover
- James L. Klosky, Fang Wang, Kathryn M. Russell, Hui Zhang, Jessica S. Flynn, Lu Huang, and William H. Kutteh, St Jude Children’s Research Hospital, Memphis, TN; Karen Wasilewski-Masker, Children’s Healthcare of Atlanta and Emory University, Atlanta, GA; Wendy Landier, City of Hope, Duarte; Jacqueline Casillas, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marcia Leonard, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI; Karen H. Albritton, Cook Children’s Medical Center, Fort Worth; Leslie R. Schover, MD Anderson Cancer Center, Houston, TX; Abha A. Gupta, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Paul Colte, Primary Children’s Hospital, Salt Lake City, UT
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Logan S, Perz J, Ussher J, Peate M, Anazodo A. Clinician provision of oncofertility support in cancer patients of a reproductive age: A systematic review. Psychooncology 2017; 27:748-756. [DOI: 10.1002/pon.4518] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/25/2017] [Accepted: 07/27/2017] [Indexed: 02/05/2023]
Affiliation(s)
- S. Logan
- School of Women and Children's Health, Faculty of Medicine; UNSW Australia; Sydney Australia
| | - J. Perz
- Centre for Health Research, School of Medicine; Western Sydney University; Sydney Australia
| | - J. Ussher
- Centre for Health Research, School of Medicine; Western Sydney University; Sydney Australia
| | - M. Peate
- Psychosocial Health and Wellbeing (emPoWeR) Unit, Department of Obstetrics and Gynaecology, Royal Women's Hospital; University of Melbourne; Melbourne Australia
| | - A. Anazodo
- School of Women and Children's Health, Faculty of Medicine; UNSW Australia; Sydney Australia
- Kids Cancer Centre Sydney Children's Hospital; Sydney Australia
- Nelune Comprehensive Cancer Centre; Prince of Wales Hospital; Sydney Australia
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18
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Affiliation(s)
- Brian T Caldwell
- Department of Pediatric Urology, Children's Hospital Colorado, 13123 E. 16th Avenue, Box 463, Aurora, CO 80045, USA; Division of Urology, Department of Surgery, University of Colorado School of Medicine, 13123 E. 16th Avenue, Box 463, Aurora, CO 80045, USA.
| | - Duncan T Wilcox
- Department of Pediatric Urology, Children's Hospital Colorado, 13123 E. 16th Avenue, Box 463, Aurora, CO 80045, USA; Division of Urology, Department of Surgery, University of Colorado School of Medicine, 13123 E. 16th Avenue, Box 463, Aurora, CO 80045, USA
| | - Nicholas G Cost
- Department of Pediatric Urology, Children's Hospital Colorado, 13123 E. 16th Avenue, Box 463, Aurora, CO 80045, USA; Division of Urology, Department of Surgery, University of Colorado School of Medicine, 13123 E. 16th Avenue, Box 463, Aurora, CO 80045, USA
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Expression and clinical association of programmed cell death-1, programmed death-ligand-1 and CD8 + lymphocytes in primary sarcomas is subtype dependent. Oncotarget 2017; 8:71371-71384. [PMID: 29050367 PMCID: PMC5642642 DOI: 10.18632/oncotarget.19071] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 06/27/2017] [Indexed: 01/26/2023] Open
Abstract
In order to explore the potential of immune checkpoint blockade in sarcoma, we investigated expression and clinical relevance of programmed cell death-1 (PD-1), programmed death ligand-1 (PD-L1) and CD8 in tumors of 208 sarcoma patients. Primary untreated osteosarcoma (n = 46), Ewing sarcoma (n = 32), alveolar rhabdomyosarcoma (n = 20), embryonal rhabdomyosarcoma (n = 77), synovial sarcoma (n = 22) and desmoplastic small round cell tumors (DSRCT) (n = 11) were examined immunohistochemically. PD-L1 expression was predominantly detected in alveolar and embryonal rhabdomyosarcomas (15% and 16%, respectively). In the alveolar subtype PD-L1 expression was associated with better overall, event-free and metastases-free survival. PD-1 expression on lymphocytes was predominantly seen in synovial sarcomas (18%). High levels of CD8+ lymphocytes were predominantly detected in osteosarcomas (35%) and associated with worse event-free survival in synovial sarcomas. Ewing sarcoma and DSRCTs showed PD-1 on tumor cells instead of on tumor infiltrating lymphocytes. Overall, expression and clinical associations were found to be subtype dependent. For the first time PD-1 expression on Ewing sarcoma (19%) and DSRCT (82%) tumor cells was described.
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FIUZA-LUCES CARMEN, PADILLA JULIOR, SOARES-MIRANDA LUISA, SANTANA-SOSA ELENA, QUIROGA JAIMEV, SANTOS-LOZANO ALEJANDRO, PAREJA-GALEANO HELIOS, SANCHIS-GOMAR FABIÁN, LORENZO-GONZÁLEZ ROSALÍA, VERDE ZORAIDA, LÓPEZ-MOJARES LUISM, LASSALETTA ALVARO, FLECK STEVENJ, PÉREZ MARGARITA, PÉREZ-MARTÍNEZ ANTONIO, LUCIA ALEJANDRO. Exercise Intervention in Pediatric Patients with Solid Tumors. Med Sci Sports Exerc 2017; 49:223-230. [DOI: 10.1249/mss.0000000000001094] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kieran K, Shnorhavorian M. Current standards of care in bladder and prostate rhabdomyosarcoma. Urol Oncol 2016; 34:93-102. [PMID: 26776454 DOI: 10.1016/j.urolonc.2015.12.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 12/21/2015] [Accepted: 12/21/2015] [Indexed: 11/25/2022]
Abstract
Rhabdomyosarcoma (RMS) is the most common soft tissue tumor in children, and 15% to 20% arise from the genitourinary tract. Multicenter collaborative studies have improved survival substantially, and in addition to excellent oncologic control, current treatment focuses on organ preservation and minimization of late treatment effects. The multiple modalities needed to treat RMS dictate that treating physicians must be familiar with the disease as well as the goals and possible sequelae of treatment with chemotherapy, radiotherapy, and surgery. This article discusses the current standards of care for bladder and prostate RMS.
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Abstract
Pediatric non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) are a heterogeneous group encompassing more than 50 different histological diagnoses arising from primitive mesenchymal tissue. Together, they comprise about half the soft tissue sarcomas diagnosed in children and young adults. Despite each histologies relative rarity, their management schema is similar among the different NRSTS histologies. Surgical management is an important component of the multimodal treatment strategy of all these tumors. Resection with negative margins, while maintaining function, plays an important role as a primary treatment of these patients as well as diminishing the risks of local and distant recurrence.
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Affiliation(s)
- Roshni Dasgupta
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children׳s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, Ohio 45229.
| | - David Rodeberg
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina
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23
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Hosoi H. Current status of treatment for pediatric rhabdomyosarcoma in the USA and Japan. Pediatr Int 2016; 58:81-7. [PMID: 26646016 DOI: 10.1111/ped.12867] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 11/25/2015] [Indexed: 02/05/2023]
Abstract
This article reviews the current status of treatment for children with rhabdomyosarcoma, according to the four risk groups. Low-risk subgroup A: the Children's Oncology Group in the USA recently performed a clinical trial consisting of a chemotherapy regimen with a shortened treatment period and a reduced drug dosage. Patients in this group received only four cycles of vincristine and actinomycin D (VA) after four cycles of vincristine, actinomycin D, and cyclophosphamide (VAC) with cyclophosphamide (CPM) 1.2 g/m(2) and their outcome was no worse than that obtained with previous regimens. Low-risk subgroup B: although marked improvement in survival was seen with an intensive VAC regimen with CPM 2.2 g/m(2) /cycle (Intergroup Rhabdomyosarcoma Study [IRS]-V, 1997-2004), the total dose of CPM in this regimen caused serious and fatal hepatic veno-occlusive disease during treatment and probably cannot avoid infertility or possible secondary cancer as a late effect. Thereafter, a reduced-dose regimen consisting of four cycles of VAC with CPM 1.2 g/m(2) followed by 12 cycles of VA was investigated in the next study, but the outcome appeared to be worse than in IRS-V. Intermediate-risk group: no significant difference was found between VAC/vincristine, topotecan and cyclophispahamide (VTC) and intensive VAC in IRS-V. The results of a subsequent regimen of VAC with CPM 1.2 g/m(2) alternating with vincristine and irinotecan are awaited. High-risk group: overall survival is approximately 30% and has not improved over the last 25 years. Although 18 month failure-free survival (FFS) was improved with an intensive combination therapy regimen, 36 month FFS dropped to 32% and thus better novel approaches or additive treatments are needed.
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Affiliation(s)
- Hajime Hosoi
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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24
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Friedman GK, Beierle EA, Gillespie GY, Markert JM, Waters AM, Chen CY, Denton NL, Haworth KB, Hutzen B, Leddon JL, Streby KA, Wang PY, Cripe TP. Pediatric cancer gone viral. Part II: potential clinical application of oncolytic herpes simplex virus-1 in children. MOLECULAR THERAPY-ONCOLYTICS 2015; 2:S2372-7705(16)30018-3. [PMID: 26436134 PMCID: PMC4589754 DOI: 10.1038/mto.2015.16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Oncolytic engineered herpes simplex viruses (HSVs) possess many biologic and functional attributes that support their use in clinical trials in children with solid tumors. Tumor cells, in an effort to escape regulatory mechanisms that would impair their growth and progression, have removed many mechanisms that would have protected them from virus infection and eventual virus-mediated destruction. Viruses engineered to exploit this weakness, like mutant HSV, can be safely employed as tumor cell killers, since normal cells retain these antiviral strategies. Many preclinical studies and early phase trials in adults demonstrated that oncolytic HSV can be safely used and are highly effective in killing tumor cells that comprise pediatric malignancies, without generating the toxic side effects of nondiscriminatory chemotherapy or radiation therapy. A variety of engineered viruses have been developed and tested in numerous preclinical models of pediatric cancers and initial trials in patients are underway. In Part II of this review series, we examine the preclinical evidence to support the further advancement of oncolytic HSV in the pediatric population. We discuss clinical advances made to date in this emerging era of oncolytic virotherapy.
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Affiliation(s)
- Gregory K Friedman
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Elizabeth A Beierle
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - James M Markert
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Alicia M Waters
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Chun-Yu Chen
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA ; Center for Childhood Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Nicholas L Denton
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Kellie B Haworth
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA ; Center for Childhood Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Brian Hutzen
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Jennifer L Leddon
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Keri A Streby
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA ; Center for Childhood Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Pin-Yi Wang
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Timothy P Cripe
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA ; Center for Childhood Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
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Stokke J, Sung L, Gupta A, Lindberg A, Rosenberg AR. Systematic review and meta-analysis of objective and subjective quality of life among pediatric, adolescent, and young adult bone tumor survivors. Pediatr Blood Cancer 2015; 62:1616-29. [PMID: 25820683 PMCID: PMC4515170 DOI: 10.1002/pbc.25514] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 02/23/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pediatric, adolescent, and young adult survivors of bone sarcomas are at risk for poor quality of life (QOL). We conducted a systematic review and meta-analysis to summarize the literature describing QOL in this population and differences in QOL based on local control procedures. PROCEDURE Included studies described ≥5 patients <25 years old who had completed local control treatment for bone sarcoma, defined QOL as a main outcome, and measured it with a validated instrument. Data extraction and quality assessments were conducted with standardized tools. Meta-analyses compared QOL based on surgical procedure (limb-sparing vs. amputation) and were stratified by assessment type (objective physical function, clinician-assessed disability, patient-reported disability, and patient-reported QOL). Effect sizes were reported as the standard mean difference when multiple instruments were used within a comparison and weighted mean difference otherwise. All were weighted by inverse variance and modeled with random effects. RESULTS Twenty-two of 452 unique manuscripts were included in qualitative syntheses, eight of which were included in meta-analyses. Manuscripts were heterogeneous with respect to included patient populations (age, tumor type, time since treatment) and QOL instruments. Prospective studies suggested that QOL improves over time, and that female sex and older age at diagnosis are associated with poor QOL. Meta-analyses showed no differences in outcomes between patients who underwent limb-sparing versus amputation for local control. CONCLUSION QOL studies among children and AYAs with bone sarcoma are remarkably diverse, making it difficult to detect trends in patient outcomes. Future research should focus on standardized QOL instruments and interpretations.
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Affiliation(s)
- Jamie Stokke
- Seattle Children’s Hospital; Seattle, WA; USA,University of Washington; Seattle, WA; USA
| | - Lillian Sung
- Hospital for Sick Children; Toronto, Ontario, CANADA
| | - Abha Gupta
- Hospital for Sick Children; Toronto, Ontario, CANADA,University of Toronto; Toronto, Ontario, CANADA
| | - Antoinette Lindberg
- Seattle Children’s Hospital; Seattle, WA; USA,University of Washington; Seattle, WA; USA
| | - Abby R. Rosenberg
- Seattle Children’s Hospital; Seattle, WA; USA,University of Washington; Seattle, WA; USA,Fred Hutchinson Cancer Research Center, Seattle, WA; USA,Treuman Katz Center for Pediatric Bioethics, Seattle, WA; USA
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Raciborska A, Bilska K, Filipp E, Drabko K, Rogowska E, Chaber R, Pogorzała M, Połczyńska K, Adrianowska N, Rodriguez-Galindo C, Maciejewski T. Ovarian function in female survivors after multimodal Ewing sarcoma therapy. Pediatr Blood Cancer 2015; 62:341-345. [PMID: 25399867 DOI: 10.1002/pbc.25304] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 09/14/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND With advances in cancer care, more young women with Ewing sarcoma (ES) survive after treatment. Thus, we sought to analyze the ovarian function in prepubertal, pubertal and postpubertal females and young women receiving multimodal therapy for ES, and to identify patients at risk of infertility on whom fertility preservation would be indicated. PROCEDURES Twenty-seven female survivors of ES were included in this retrospective multiinstitutional study. Patients were classified into four groups according to the treatment received: chemotherapy (CHT) without pelvic radiation (pRT), chemotherapy and pRT, CHT and autologous hematopoietic cell stem rescue (aHSCT) without pRT, and CHT + pRT + aHSCT. The ovarian function and fertility outcomes were analyzed. RESULTS At a median follow-up of 5.7 years from diagnosis, and at median age at follow-up of 16.3 years, 67% of the survivors had premature ovarian insufficiency, including all patients receiving pelvic RT and 87.5% of patients who underwent aHSCT, independent of chemoprotection. Thirty-seven percent of patients had a clinical syndrome of premature menopause. The relative risk (RR) of premature ovarian insufficiency of a survivor was 3.9 (p 0.03) for pRT, and 2.4 (p 0.07) for aHSCT. On multivariate analysis, radiation therapy was a significant predictor of higher risk of premature ovarian insufficiency over chemotherapy alone. CONCLUSIONS A large proportion of women receiving multimodal therapy for ES develop premature ovarian insufficiency. Patients and guardians should be informed about the reproductive potential and strategies for preservation of ovarian function should be considered individually. Pediatr Blood Cancer 2015;62:341-345. © 2014 Wiley Periodicals, Inc.
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Affiliation(s)
- Anna Raciborska
- Department of Surgical Oncology for Children and Youth, Institute of Mother and Child, Warsaw, Poland
| | - Katarzyna Bilska
- Department of Surgical Oncology for Children and Youth, Institute of Mother and Child, Warsaw, Poland
| | - Ewa Filipp
- Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland
| | - Katarzyna Drabko
- Department of Pediatric Hematology, Oncology and Transplant, Medical University of Lublin, Lublin, Poland
| | - Elżbieta Rogowska
- Department of Surgical Oncology for Children and Youth, Institute of Mother and Child, Warsaw, Poland
| | - Radosław Chaber
- Department and Clinic of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Monika Pogorzała
- Department of Pediatric Hematology and Oncology Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Katarzyna Połczyńska
- Department of Pediatric Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Natalia Adrianowska
- Department of Paediatric Hematology and Oncology, Medical University of Lodz, Lodz, Poland
| | - Carlos Rodriguez-Galindo
- Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts
| | - Tomasz Maciejewski
- Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland
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Youn P, Milano MT, Constine LS, Travis LB. Long-term cause-specific mortality in survivors of adolescent and young adult bone and soft tissue sarcoma: A population-based study of 28,844 patients. Cancer 2014; 120:2334-42. [DOI: 10.1002/cncr.28733] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 02/07/2014] [Accepted: 02/26/2014] [Indexed: 12/21/2022]
Affiliation(s)
- Paul Youn
- Department of Radiation Oncology and Rubin Center for Cancer Survivorship, James P. Wilmot Cancer Center; University of Rochester Medical Center; Rochester New York
| | - Michael T. Milano
- Department of Radiation Oncology and Rubin Center for Cancer Survivorship, James P. Wilmot Cancer Center; University of Rochester Medical Center; Rochester New York
| | - Louis S. Constine
- Department of Radiation Oncology and Rubin Center for Cancer Survivorship, James P. Wilmot Cancer Center; University of Rochester Medical Center; Rochester New York
| | - Lois B. Travis
- Department of Radiation Oncology and Rubin Center for Cancer Survivorship, James P. Wilmot Cancer Center; University of Rochester Medical Center; Rochester New York
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Kwong TNK, Furtado S, Gerrand C. What do we know about survivorship after treatment for extremity sarcoma? A systematic review. Eur J Surg Oncol 2014; 40:1109-24. [PMID: 24767804 DOI: 10.1016/j.ejso.2014.03.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 02/20/2014] [Accepted: 03/19/2014] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The varied presentations and treatments of extremity bone and soft tissue sarcoma mean that the issues faced by survivors are diverse and complex. The aim of this systematic review was to investigate what is known about this topic with a view to identifying areas for further research or service development. METHODS This was a review of the English language literature identified from Medline and Ovid and hand searches published between January 2000 and September 2012. Results were compiled according to physical, psychological and social domains of survivorship. RESULTS Of 182 studies identified, 22 met the inclusion criteria. There is a wide range of outcome measures used and a need for more objective measures. Unsurprisingly, survivors of extremity sarcoma typically demonstrate lower levels of physical functioning than healthy controls. In addition, survivors demonstrate a substantial psychological morbidity. CONCLUSIONS Services for survivors of extremity sarcoma should include rehabilitation and psychological support, sexual health services, expert pain management, and support to return to work.
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Affiliation(s)
- T Ng Kee Kwong
- University Hospital of North Tees, TS19 8PE, United Kingdom
| | - S Furtado
- Department of Orthopaedics, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, United Kingdom
| | - C Gerrand
- North of England Bone and Soft Tissue Tumour Service, Department of Orthopaedics, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, United Kingdom.
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Williams LK, Drew S, Deluca CR, McCarthy MC. Screening for Psychological Well-Being in Childhood Cancer Survivors: A Preliminary Assessment of the Feasibility of the Strength and Difficulties Questionnaire as a Parent-Proxy Report. J Psychosoc Oncol 2013; 31:601-16. [DOI: 10.1080/07347332.2013.835019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ouyang ZX, Li XA. Inhibitory effects of tamoxifen and doxorubicin, alone and in combination, on the proliferation of the MG63 human osteosarcoma cell line. Oncol Lett 2013; 6:970-976. [PMID: 24137447 PMCID: PMC3796417 DOI: 10.3892/ol.2013.1487] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 07/10/2013] [Indexed: 12/02/2022] Open
Abstract
The present study aimed to compare the combined effect of tamoxifen (TAM) and doxorubicin (ADM) with the individual effects of TAM and ADM alone on the MG63 human osteosarcoma cell line. Estrogen receptor (ER) expression was detected in the MG63 cells using reverse transcription PCR. The morphological changes during the inhibition of cell growth were observed using an inverted microscope and a 3-(4, 5-dimethy1-2-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) colorimetric assay following the individual or combined addition of TAM and ADM. ERα and ERβ expression was detected in the MG63 cells. The typical apoptotic cell morphology was observed in all groups, with the exception of the control group. The MTT colorimetric analysis demonstrated that the rate of inhibition of cell proliferation in the combination group was significantly increased compared with that in the other groups (P<0.05). ERα and ERβ expression was detected in the MG63 human osteosarcoma cells. TAM and ADM alone were able to inhibit cell proliferation. The combination of TAM and ADM significantly enhanced the inhibitory effect, partly through the enhanced sensitivity of the cells to ADM by TAM, which caused the inhibition of cell proliferation and apoptosis.
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Affiliation(s)
- Zheng-Xiao Ouyang
- Department of Orthopaedics, Hunan Provincial Tumor Hospital and Tumor Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, P.R. China
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Klosky JL, Foster RH, Nobel AM. Pediatric Oncology and Reproductive Health. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2012; 732:151-64. [DOI: 10.1007/978-94-007-2492-1_12] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Hagleitner MM, Hoogerbrugge PM, van der Graaf WTA, Flucke U, Schreuder HWB, te Loo DMWM. Age as prognostic factor in patients with osteosarcoma. Bone 2011; 49:1173-7. [PMID: 21893224 DOI: 10.1016/j.bone.2011.08.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 08/11/2011] [Accepted: 08/15/2011] [Indexed: 11/28/2022]
Abstract
Age at diagnosis is a well known prognostic factor in many different malignancies; its significance for patients with osteosarcoma is however controversial. To gain more insight in the prognostic role of age, we performed a retrospective study at our institute. We included 102 patients with de-novo osteosarcoma and formed three age groups to evaluate age specific survival rates: ≤ 14 years, 15-19 years and 20-40 years. Differences in outcome between patients aged 15-19 years treated at either the pediatric department or the adult department of oncology were evaluated. The 5-year overall survival rate (OSR) of the whole population was 53.5%±1.5%. OSR of 70.6%±0.8% was seen in patients ≤ 14 years old, 52.5%±1.1% in patients 15-19 years old and 33.3%±0.9% in the patients aged 20-40 years (p=0.01). Significant differences were observed with regard to stage at presentation (higher in older age groups), size of the tumor (larger in younger age groups) and histological response (more good responders in younger age groups). No significant difference was seen between outcomes of patients aged 15-19 years treated at the pediatric or adult oncology department. In conclusion, younger patients have a significantly better outcome than older patients.
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Affiliation(s)
- Melanie M Hagleitner
- Department of Pediatric Hematology and Oncology, Radboud University Nijmegen Medical Centre, 6500HB Nijmegen, The Netherlands.
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Abstract
The current concepts, recommendations, and principles of sperm banking as it pertains to the comprehensive care of young men of reproductive age with cancer are reviewed. Obstacles to sperm banking are addressed as well as future directions for fertility-preserving technologies. All cancer therapies-chemotherapy, radiation, and surgery-are potential threats to a man's reproductive potential. In addition, cancer itself can impair spermatogenesis. Thus, sperm cryopreservation prior to initiating life-saving cancer treatment offers men and their families the best chance to father biologically related children and should be offered to all men with cancer before treatment. Better patient and provider education, as well as deliberate, coordinated strategies at comprehensive cancer care centers are necessary to make fertility preservation for male cancer patients a priority during pretreatment planning.
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Affiliation(s)
- Daniel H Williams
- Department of Urology, University of Wisconsin-Madison,600 Highland Avenue,Madison, WI 53792, USA
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Anxiety and depression in sarcoma patients: Emotional adjustment and its determinants in the different phases of disease. Eur J Oncol Nurs 2011; 15:73-9. [DOI: 10.1016/j.ejon.2010.06.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 04/27/2010] [Accepted: 06/24/2010] [Indexed: 11/15/2022]
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Impacto do cancro do osso e tecidos moles no ajustamento emocional e qualidade de vida. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s0870-9025(11)70006-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Montgomery M, Huang S, Cox CL, Leisenring WM, Oeffinger KC, Hudson MM, Ginsberg J, Armstrong GT, Robison LL, Ness KK. Physical therapy and chiropractic use among childhood cancer survivors with chronic disease: impact on health-related quality of life. J Cancer Surviv 2010; 5:73-81. [PMID: 20922492 DOI: 10.1007/s11764-010-0151-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Accepted: 09/21/2010] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The use of rehabilitation services to address musculoskeletal, neurological and cardiovascular late effects among childhood cancer survivors could improve physical function and health-related quality-of-life (HRQL). We describe physical therapy (PT) and chiropractic utilization among childhood cancer survivors and their association with HRQL. METHODS The sample included 5+ year survivors from the Childhood Cancer Survivor Study (N = 9,289). Questions addressing use of PT or chiropractic services and HRQL (Medical Outcomes Survey Short Form (SF-36)) were evaluated. Multivariable regression models compared PT and/or chiropractic utilization between survivors and siblings, and by diagnosis, treatment and demographic characteristics; associations between chronic disease, PT/chiropractic use, and HRQL were similarly evaluated. RESULTS Survivors were not more likely to use PT (OR 1.0; 95% CI 0.8-1.2) or chiropractic (OR 0.8; 95% CI 0.7-1.0) services than siblings. More survivors reported using chiropractic (12.4%) than PT (9.2%) services. Older age and having health insurance were associated with utilization of either PT or chiropractic services. Grade 3-4 chronic conditions and a CNS tumor or sarcoma history were associated with PT but not with chiropractic service utilization. Survivors with musculoskeletal (OR 1.8; 95% CI 1.1-2.9), neurological (OR 3.4; 95% CI 1.6-6.9), or cardiovascular (OR 3.3; 95% CI 1.6-6.9) chronic conditions who used PT/chiropractic services were more likely to report poor physical health than survivors who did not use services. CONCLUSIONS The reported prevalence of PT/chiropractic among survivors is consistent with that reported by siblings. Severity of late effects is associated with service use and with reporting poor physical health. IMPLICATIONS FOR CANCER SURVIVORS Long-term childhood cancer survivors do not appear to utilize rehabilitation services to optimize physical function and support increased HRQL.
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Affiliation(s)
- Michele Montgomery
- Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, USA.
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Ginsberg JP, Goodman P, Leisenring W, Ness KK, Meyers PA, Wolden SL, Smith SM, Stovall M, Hammond S, Robison LL, Oeffinger KC. Long-term survivors of childhood Ewing sarcoma: report from the childhood cancer survivor study. J Natl Cancer Inst 2010; 102:1272-83. [PMID: 20656964 DOI: 10.1093/jnci/djq278] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The survival of Ewing sarcoma (ES) patients has improved since the 1970s but is associated with considerable future health risks. METHODS The study population consisted of long-term (> or =5-year) survivors of childhood ES diagnosed before age 21 from 1970 to 1986. Cause-specific mortality was evaluated in eligible survivors (n = 568), and subsequent malignant neoplasms, chronic health conditions, infertility, and health status were evaluated in the subset participating in the Childhood Cancer Survivor Study (n = 403). Outcomes were compared with the US population and sibling control subjects (n = 3899). Logistic, Poisson, or Cox proportional hazards models, with adjustments for sex, age, race/ethnicity, and potential intrafamily correlation, were used. Statistical tests were two-sided. RESULTS Cumulative mortality of ES survivors was 25.0% (95% confidence interval [CI] = 21.1 to 28.9) 25 years after diagnosis. The all-cause standardized mortality ratio was 13.3 (95% CI = 11.2 to 15.8) overall, 23.1 (95% CI = 17.6 to 29.7) for women, and 10.0 (95% CI = 7.9 to 12.5) for men. The nonrecurrence-progression non-external cause standardized mortality ratio (subsequent non-ES malignant neoplasms and cardiac and pulmonary causes potentially attributable to ES treatment) was 8.7 (95% CI = 6.2 to 12.0). Twenty-five years after ES diagnosis, cumulative incidence of subsequent malignant neoplasms, excluding nonmelanoma skin cancers, was 9.0% (95% CI = 5.8 to 12.2). Compared with siblings, survivors had an increased risk of severe, life-threatening, or disabling chronic health conditions (relative risk = 6.0, 95% CI = 4.1 to 9.0). Survivors had lower fertility rates (women: P = .005; men: P < .001) and higher rates of moderate to extreme adverse health status (P < .001). CONCLUSION Long-term survivors of childhood ES exhibit excess mortality and morbidity.
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Affiliation(s)
- Jill P Ginsberg
- Division of Oncology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania, School of Medicine, Colket Translational Research Bldg, 3501 Civic Center Blvd, 10th Floor, Philadelphia, PA 19104, USA.
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Skinner R, Parry A, Price L, Cole M, Craft AW, Pearson ADJ. Glomerular toxicity persists 10 years after ifosfamide treatment in childhood and is not predictable by age or dose. Pediatr Blood Cancer 2010; 54:983-9. [PMID: 20405516 DOI: 10.1002/pbc.22364] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This prospective longitudinal single institution cohort study evaluated the natural history of and risk factors for chronic nephrotoxicity 10 years after ifosfamide treatment in childhood. PROCEDURE Twenty-five patients (16 males) treated with ifosfamide were investigated at end of treatment (End), 1 and 10 years later. Glomerular filtration rate (GFR), serum phosphate (PO4) and bicarbonate (HCO3) and renal tubular threshold for phosphate (Tmp/GFR) were measured, and total nephrotoxicity score (Ns) graded. RESULTS More patients had a low GFR at 1 (72%) and 10 (50%) years than at End (26%) (P = 0.006 for End vs. 1 year). Electrolyte supplementation requirements for tubular toxicity resolved by 10 years (0% vs. 32% at End and 24% at 1 year; both P < 0.05). At 10 years, 17% of patients had moderate overall nephrotoxicity and 13% clinically significant reduction of GFR (<60 ml/min/1.73 m2). Neither dose nor age at treatment predicted any measure of toxicity at 10 years or reduced GFR at any timepoint. Higher cumulative ifosfamide dose correlated with greater tubular and overall nephrotoxicity at End and/or 1 year (P < 0.05 for each of PO4, HCO3, Tmp/GFR, Ns), but age at treatment did not differ between patients with normal or abnormal results. CONCLUSIONS Although clinically significant tubular toxicity had resolved by 10 years, GFR was <60 ml/min/1.73 m2 in 13% of patients, raising concerns about very long-term glomerular function. Higher cumulative dose was associated with greater tubular and overall toxicity at End and 1 year, but not at 10 years. Age at treatment did not predict nephrotoxicity at any timepoint.
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Affiliation(s)
- Roderick Skinner
- Department of Paediatric and Adolescent Oncology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
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Local therapy for rhabdomyosarcoma of the hands and feet: is amputation necessary? A report from the Children's Oncology Group. Int J Radiat Oncol Biol Phys 2010; 80:206-12. [PMID: 20646853 DOI: 10.1016/j.ijrobp.2010.01.053] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 01/21/2010] [Accepted: 01/26/2010] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate the outcome of children with rhabdomyosarcoma (RMS) of the hand or foot treated with surgery and/or local radiotherapy (RT). METHODS AND MATERIALS Forty-eight patients with nonmetastatic RMS of the hand or foot were enrolled on Intergroup Rhabdomyosarcoma Study III, IV-Pilot, and IV. Patients received multiagent chemotherapy with surgery and/or RT. Twenty-four patients (50%) underwent surgery without local RT, of whom 4 had complete resection and 20 had an amputation. The remaining 24 patients (50%) underwent local RT, of whom 2 required RT for microscopic residual disease after prior amputation. Median follow-up for surviving patients was 9.7 years. RESULTS Actuarial 10-year local control was 100%; 10-year event-free survival and overall survival rates were 62% and 63%, respectively. Poor prognostic factors for recurrence included gross residual (Group III) disease and nodal involvement (p = 0.01 and 0.05, respectively). More patients in the RT group had alveolar histology, Group III disease, and nodal involvement, as compared with the surgery group. There was no difference in 10-year event-free survival (57% vs. 66%) or overall survival (63% vs. 63%) between patients who underwent surgery or local RT. Among relapsing patients, there were no long-term survivors. No secondary malignancies have been observed. CONCLUSIONS Despite having high-risk features, patients treated with local RT achieved excellent local control. Complete surgical resection without amputation is difficult to achieve in the hand or foot. Therefore, we recommend either definitive RT or surgical resection that maintains form and function as primary local therapy rather than amputation in patients with hand or foot RMS.
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Surviving childhood and reproductive-age malignancy: effects on fertility and future parenthood. Lancet Oncol 2010; 11:490-8. [PMID: 20153978 DOI: 10.1016/s1470-2045(09)70317-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Annually, more than 50,000 cancer diagnoses are made in the USA in patients under the age of 35 years. Despite this staggering statistic, medical advancements have substantially improved survival rates. Thus, for both male and female patients with cancer, quality-of-life issues, such as fertility preservation and parenthood, have become an essential component of treatment. Unfortunately, many of the treatments to eradicate malignant processes can also compromise reproductive function. In these cases, fertility preservation should be discussed and initiated with early treatment planning, to allow the best chance for future parenthood, when appropriate. The effects of cancer and cancer treatments on fertility and future parenthood, including health risks for patients, their gametes, and offspring are discussed.
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Oeffinger KC, Nathan PC, Kremer LC. Challenges After Curative Treatment for Childhood Cancer and Long-Term Follow up of Survivors. Hematol Oncol Clin North Am 2010; 24:129-49. [DOI: 10.1016/j.hoc.2009.11.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Merchant MS. Long-term impact of cancer care on activities of daily living: are we causing our sarcoma survivors to grow up too quickly? Pediatr Blood Cancer 2009; 53:531-2. [PMID: 19588522 DOI: 10.1002/pbc.22166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Melinda S Merchant
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-1104, USA.
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Parks R, Rasch EK, Mansky PJ, Oakley F. Differences in activities of daily living performance between long-term pediatric sarcoma survivors and a matched comparison group on standardized testing. Pediatr Blood Cancer 2009; 53:622-8. [PMID: 19533662 PMCID: PMC2825086 DOI: 10.1002/pbc.22101] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND In a cross-sectional study examining late effects of pediatric sarcoma therapy, long-term survivors were evaluated on their activities of daily living (ADL) performance. PROCEDURE Thirty-two persons with Ewing sarcoma family of tumors, rhabdomyosarcoma, and non-rhabdomysarcoma-soft tissue sarcoma enrolled an average of 17 years after treatment. Participants were evaluated using the Assessment of Motor and Process Skills (AMPS) 1, a standardized observational evaluation of ADL task performance. Means and 95% confidence intervals for ADL motor and ADL process ability measures were calculated for four groups: (1) sarcoma survivors, (2) "well" adults matched for age and gender, (3) "well" adults matched for gender that were 10 years older, and (4) "well" adults matched for gender that were 20 years older. RESULTS ADL motor ability was significantly lower for sarcoma survivors than for the age- and gender-matched comparison group (P < 0.05). There was no significant difference between ADL motor ability of sarcoma survivors and the comparison group 10 years older, but sarcoma survivors had significantly better ADL motor ability (P < 0.05) than the oldest comparison group (20 years older). Sarcoma survivors had significantly worse ADL process ability than the age-matched group (P < 0.05). There was no difference in ADL process ability between the sarcoma survivors and comparison groups that were 10 and 20 years older. CONCLUSIONS This first report of a clinical evaluation of ADL limitation in pediatric sarcoma survivors treated with intensive multimodal cancer therapy suggests that influences on performance of daily life activities are more common than previously reported.
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Affiliation(s)
- Rebecca Parks
- Rehabilitation Medicine Department, Mark O. Hatfield Clinical Research Center, National Institutes of Health, Bethesda, Maryland, USA.
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Aksnes LH, Bauer HCF, Dahl AA, Fosså SD, Hjorth L, Jebsen N, Lernedal H, Hall KS. Health status at long-term follow-up in patients treated for extremity localized Ewing Sarcoma or osteosarcoma: a Scandinavian sarcoma group study. Pediatr Blood Cancer 2009; 53:84-9. [PMID: 19343771 DOI: 10.1002/pbc.22027] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The purpose of this study was to evaluate late effects and symptom complaints in long-term survivors (>5 years) of Extremity Bone Sarcoma (EBS survivors). The results were compared with findings in age- and gender-matched individuals from the general population (NORMs). PATIENTS AND METHODS Among 155 EBS survivors approached, 133 (86%) were included, and 110 of them (83%) attended an outpatient examination. Health status was evaluated by a mailed questionnaire concerning demographic and current health issues, and physical examinations at the outpatient clinic. Age- and gender-adjusted normative controls were drawn from participants of the Health Study of Nord-Trøndelag County (HUNT 2). RESULTS Median age at follow-up was 29 (15-57) years. Median follow-up was 12 (6-22) years. Of EBS survivors 42% had > or =1 somatic disease, 33% had ototoxicity and 13% had reduced renal function. EBS survivors were more likely to have heart disease (odds ratio [OR], 7.9; 95% confidence interval [95% CI], 2.5-25.3; P = 0.001), hypertension (OR, 3.4; 95% CI, 1.1-10.1; P = 0.03) and thyroid disease (OR, 3.0; 95% CI, 1.1-8.3; P = 0.04) compared to NORMs. EBS survivors reported more diarrhoea (29% vs. 19%, P = 0.02), palpitations (23% vs. 13%, P = 0.01) and shortness of breath (11% vs. 5%, P = 0.01) than NORMs. CONCLUSIONS EBS survivors have poorer health status compared to age- and gender-matched controls. Long-term follow-up of these patients is therefore mandatory.
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Affiliation(s)
- L H Aksnes
- Department of Oncology, The Norwegian Radium Hospital, Rikshospitalet University Hospital, Oslo, Norway.
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Ottaviani G, Robert RS, Huh WW, Jaffe N. Functional, psychosocial and professional outcomes in long-term survivors of lower-extremity osteosarcomas: amputation versus limb salvage. Cancer Treat Res 2009; 152:421-436. [PMID: 20213405 DOI: 10.1007/978-1-4419-0284-9_23] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
As the number of osteosarcoma survivors increases, the impact of quality of life and function needs to be addressed. Limb salvage is the preferred treatment when patients have treatment options; yet, the questionable long-term durability and complications of prostheses, combined with ambiguous function, leave some doubt regarding the best clinical and surgical options. Comparisons between limb salvage patients, amputees and controls also require further investigation. Amputation would leave the patients with a lifelong requirement for an external prosthetic leg associated with an overall limited walking distance. While artificial limbs are much more sophisticated than those used in the past, phantom limb sensations remain a substantial and unpredictable problem in the amputee. Complications such as stump overgrowth, bleeding, and infection, also require further elucidation. Limb salvage surgery using endoprosthesis, allografts or reconstruction is performed in approximately 85% of patients affected by osteosarcoma located in the middle and/or distal femur. One drawback in limb-salvage surgery in the long-term survivor is that endoprostheses have a limited life span with long-term prosthetic failure. The inherent high rate of reoperation remains a serious problem. Replacing a damaged, infected or severely worn-out arthroplastic joint or its intramedullary stem is difficult, especially in the long-stem cemented endoprostheses used in the 1980s. Limb lengthening procedures in patients who have not reached maturity must also be addressed. Periprosthetic infections, compared to other indications for joint reconstruction, were found to be more frequent in patients treated for neoplastic conditions and their outcome can be devastating, resulting in total loss of joint function, amputation, and systemic complications. Quality of life in terms of function, psychological outcome and endpoint achievements such as marriage and employment apparently do not differ significantly between amputee and nonamputee osteosarcoma survivors. Amputee patients nonetheless appear to have made satisfactory adjustments to their deficits with or without a functional external prosthesis. It also appeared that amputee patients had a similar psychological and quality of life outcome as limb salvage patients. There was no evidence of excessive anxiety or depression or deficits in self-esteem compared with the normal population or matched controls. A number of long-term survivors also achieved high ranking in the professional and commercial work place. These positive aspects should be recognized and emphasized to patients and their parents when discussing the outcome.
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Affiliation(s)
- Giulia Ottaviani
- Children's Cancer Hospital, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030-4009, USA.
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Magné N, Oberlin O, Martelli H, Gerbaulet A, Chassagne D, Haie-Meder C. Vulval and Vaginal Rhabdomyosarcoma in Children: Update and Reappraisal of Institut Gustave Roussy Brachytherapy Experience. Int J Radiat Oncol Biol Phys 2008; 72:878-83. [DOI: 10.1016/j.ijrobp.2008.01.034] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2007] [Revised: 01/14/2008] [Accepted: 01/15/2008] [Indexed: 10/22/2022]
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Challenges after curative treatment for childhood cancer and long-term follow up of survivors. Pediatr Clin North Am 2008; 55:251-73, xiii. [PMID: 18242324 DOI: 10.1016/j.pcl.2007.10.009] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Childhood cancer survivors are at increased risk of serious morbidity, premature mortality, and diminished health status. Proactive and anticipatory risk-based health care of survivors and healthy lifestyles can reduce these risks. In this article, the authors first briefly discuss four common problems of survivors: neurocognitive dysfunction, cardiovascular disease, infertility and gonadal dysfunction, and psychosocial problems. Second, the authors discuss the concept of risk-based care, promote the use of recently developed evidence-based guidelines, describe current care in the United States, Canada, and the Netherlands, and articulate a model for shared survivor care that aims to optimize life long health of survivors and improve two-way communication between the cancer center and the primary care physician.
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Hoffman KE, Derdak J, Bernstein D, Reynolds JC, Avila NA, Gerber L, Steinberg SM, Chrousos G, Mackall CL, Mansky PJ. Metabolic syndrome traits in long-term survivors of pediatric sarcoma. Pediatr Blood Cancer 2008; 50:341-6. [PMID: 17918262 DOI: 10.1002/pbc.21363] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The metabolic syndrome (MS), a cluster of central obesity, dyslipidemia, hyperglycemia, and hypertension, conveys an increased risk of type 2 diabetes and cardiovascular disease. This cross-sectional study investigated the prevalence of metabolic syndrome traits (MST) in long-term survivors of pediatric sarcoma (SARC) who received multi-modality therapy (MMT). METHODS Thirty-two SARC survivors (predominantly Ewings; median age 36.5; median age at MMT 15) underwent body composition, activity, and psychosocial analysis. Serum endocrine and inflammatory parameters and urine beta(2)-microglobulin (B2M) were evaluated. The prevalence of MST was compared to age- and gender-matched U.S. population data. RESULTS SARC survivors were more likely to have two or more MST (OR 2.38 95% CI: [1.14, 5.04]). Analysis of individual MST demonstrated higher prevalence of hypertension (OR 2.61 95% CI: [1.20, 5.59]), hypertriglyceridemia (OR 3.63 95% CI: [1.75, 7.60]), and male visceral abdominal obesity (20-39 years old OR 4.63 95% CI: [0.91, 21.63], 40-59 years old OR infinity). Survivors 18-39 years old had a higher prevalence of the MS (OR 4.29 95% CI: [1.50, 11.21]), defined as three or more MST. Plasminogen activator inhibitory activity (P = 0.016) and B2M (P = 0.027) increased with increasing numbers of MST. In males, total testosterone declined (P = 0.0027) as the number of MST increased. Average (P = 0.014) and maximum (P = 0.021) activity levels decreased as the number of MST increased. CONCLUSION After a median follow up of 17 years, adult SARC survivors of MMT had an increased prevalence of MST, especially those less than 40 years old. The development of MST in this population was associated with decreased testosterone and activity levels.
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Affiliation(s)
- Karen E Hoffman
- Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland, USA
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Bird BRJH, Swain SM. Cardiac toxicity in breast cancer survivors: review of potential cardiac problems. Clin Cancer Res 2008; 14:14-24. [PMID: 18172247 DOI: 10.1158/1078-0432.ccr-07-1033] [Citation(s) in RCA: 237] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
As breast cancer survival is increased by the diagnosis of earlier-stage disease and treatments improve, the side effects of cancer treatments, such as cardiotoxicity, remain clinically important. Although physicians have known for 30 years that anthracyclines cause acute and chronic cardiotoxicity, the cardiotoxic effects of radiation therapy, hormonal therapy (including tamoxifen and the aromatase inhibitors), and chemotherapy with taxanes and trastuzumab treatment have emerged more recently. This review examines the cardiac toxicity of adjuvant therapy, monitoring for early changes and existing guidelines for monitoring cardiac function in patients with breast cancer.
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Affiliation(s)
- Brian R J Healey Bird
- Breast Cancer Section, Medical Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, MD, USA
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