Abstract
Introduction: Despite decreasing mortality in pediatric oncology as a result of standardized treatment protocols, the high number of functional and cardiovascular late sequelae due to anticarcinogenic therapy remains unchanged. The aim of this study was to further assess functional limitations in Health-related Physical Fitness (HRPF) and cardiovascular risk by means of markers of arterial stiffness in Childhood Cancer Survivors (CCS).Materials and Methods: Between March 2016 and August 2017 a total of 92 CCS (Age 12.5 ± 4.2 years, 43 girls) were recruited from their routine follow-up outpatient visit. HRPF was assessed using five Fitnessgram® tasks. Pulse Wave Velocity (PWV) along with peripheral and central blood pressure were assessed using oscillometric measurements performed by Mobil-O-Graph. Z-scores were used to compare the test results either to German reference values or to a recent healthy reference cohort.Results: In CCS, the HRPF was significantly reduced (z-score: −0.28 ± 1.01, p = 0.011) as compared to healthy peers. The peripheral Systolic Blood Pressure (pSBP) was significantly increased (z-score: 0.31 ± 1.11, p = 0.017) and the peripheral Diastolic Blood Pressure (pDBP) was decreased (z-score: −0.30 ± 1.25, p = 0.040), resulting in an increased pulse pressure. The PWV (p = 0.649) and cSBP (p = 0.408), were neither increased nor showed any association to HRPF.Discussion: CCS showed functional limitations in HRPF and an increased pulse pressure, which acts as an early onset parameter of arterial stiffness. Both a low HRPF and impaired hemodynamics are independent cardiovascular risk factors and needs to be taken into consideration in tertiary prevention of CCS.
Highlights
Despite decreasing mortality in pediatric oncology as a result of standardized treatment protocols, the high number of functional and cardiovascular late sequelae due to anticarcinogenic therapy remains unchanged
More than 70% of the childhood cancer survivors (CCS) suffer from chronic health conditions [2], which are often directly associated to anticarcinogenic therapy
Most prominent were reductions in flexibility by means of sit-andreach (z-score: −0.32 ± 1.35, p = 0.032), shoulder stretch, and trunk lift (z-score: −0.45 ± 1.69, p = 0.014). 20 (21.7%) of the Cancer Survivors (CCS) showed a reduction in Health-related Physical Fitness (HRPF) z-scores < 1 standard deviation
Summary
Despite decreasing mortality in pediatric oncology as a result of standardized treatment protocols, the high number of functional and cardiovascular late sequelae due to anticarcinogenic therapy remains unchanged. The aim of this study was to further assess functional limitations in Health-related Physical Fitness (HRPF) and cardiovascular risk by means of markers of arterial stiffness in Childhood Cancer Survivors (CCS). Due to improved anticarcinogenic treatment regimens (chemotherapy and radiation) more children and adolescents are surviving a cancer diagnosis [1]. More than 70% of the childhood cancer survivors (CCS) suffer from chronic health conditions [2], which are often directly associated to anticarcinogenic therapy. Health related physical fitness (HRPF) is an indicator for the development, growths, and lifestyle of children and adolescents, and it is significantly reduced after acute treatment phase in CCS [3]. Physical activity remains reduced in CCS for years after diagnosis [4], and frailty, a complex syndrome of the elderly, can occur prematurely in CCS [5]
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