Treatment late effects in long‐term survivors of pediatric sarcoma

Mansky, Patrick J.; Arai, Andrew E.; Stratton, Pamela; Bernstein, Donna; Long, Lauren; Reynolds, James C.; Chen, Donna; Steinberg, Seth M.; Lavende, Neil; Hoffman, Karen E.; Nathan, Paul C.; Parks, Randolph W.; Augustine, Elizabeth; Chaudhry, Usha; Derdak, Joanne; Wiener, Lori; Gerber, Lynn H.; Mackall, Crystal L.

doi:10.1002/pbc.20871

Cited by 66 publications

(50 citation statements)

References 21 publications

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“…Patients with these diagnoses are at high risk of poor quality of life (QOL) compared to other childhood cancer survivors and the general population, in part because their intensive chemotherapies may be associated with frequent admissions for febrile neutropenia and risks of cardiac dysfunction, infertility, and recurrent malignancy. [3–7]…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta‐analysis of objective and subjective quality of life among pediatric, adolescent, and young adult bone tumor survivors

Stokke

Sung

Gupta

et al. 2015

Pediatric Blood & Cancer

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Background Pediatric, adolescent and young adult (AYA) 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 versus 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, 8 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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Section: Introductionmentioning

confidence: 99%

Systematic review and meta‐analysis of objective and subjective quality of life among pediatric, adolescent, and young adult bone tumor survivors

Stokke

Sung

Gupta

et al. 2015

Pediatric Blood & Cancer

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“…Cardiac magnetic resonance imaging is able to assess anthracycline cardiotoxicity (121). Delayed enhancement gadolinium imaging detects myocarditis (122).…”

Section: Cardiac Monitoringmentioning

confidence: 99%

Cardiac Toxicity in Breast Cancer Survivors: Review of Potential Cardiac Problems

Bird

Swain

2008

Clinical Cancer Research

282

171

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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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“…One-way analyses of variance with post-hoc Tukey tests were used to determine differences in ADL motor and process ability measures among three mutually exclusive sub-groups of sarcoma survivors by lesion site: axial lesions, extremity lesions without amputation, and extremity lesions with amputation. Sarcoma survivors were also classified into mutually exclusive sub-groups by the type of radiotherapy they received: total body irradiation, cranial irradiation, whole lung irradiation, local irradiation, or no irradiation (i.e., those who received surgery only) [27]. Two participants received both cranial and total body irradiation.…”

Section: Methodsmentioning

confidence: 99%

Differences in activities of daily living performance between long‐term pediatric sarcoma survivors and a matched comparison group on standardized testing

Parks

Rasch

Mansky

et al. 2009

Pediatric Blood & Cancer

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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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Treatment late effects in long‐term survivors of pediatric sarcoma

Cited by 66 publications

References 21 publications

Systematic review and meta‐analysis of objective and subjective quality of life among pediatric, adolescent, and young adult bone tumor survivors

Systematic review and meta‐analysis of objective and subjective quality of life among pediatric, adolescent, and young adult bone tumor survivors

Cardiac Toxicity in Breast Cancer Survivors: Review of Potential Cardiac Problems

Differences in activities of daily living performance between long‐term pediatric sarcoma survivors and a matched comparison group on standardized testing

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