Abstract
BackgroundMost studies on health-related quality of life (HRQOL) in children with cancer focussed on survivors. Only few studies have evaluated patients during ongoing oncological treatment. The aim of this study was a prospective assessment of HRQOL in children during the first year after diagnosis of cancer and an examination of demographic, medical, and parental predictors of HRQOL.MethodsFifty-two patients (mean age: 10.9 years) were assessed 6 weeks and 1 year after diagnosis with the TNO-AZL Questionnaire for Children's Health-Related Quality of Life. Parents completed the Brief Symptom Inventory.ResultsCompared to a community sample, patients reported more physical complaints, reduced motor functioning and autonomy, and impaired positive emotional functioning 6 weeks after diagnosis. HRQOL significantly improved over the year. However, at 1 year, patients still showed reduced motor and emotional functioning. At 6 weeks, children with leukemia were most affected. At 1 year, patients with brain tumors complained about more physical symptoms than the other groups. Intensity of treatment and presence of medical complications mainly influenced HRQOL at 6 weeks but less at 1 year. Parental psychopathology was associated with better cognitive functioning in the child.ConclusionThis prospective study found several domains of HRQOL to be compromised 6 weeks and 1 year after the diagnosis of cancer. Although HRQOL significantly increased over the year, there were important differences between diagnostic groups. The findings highlight the importance of repeated evaluation of HRQOL in children undergoing cancer treatment and consideration of specific differences between diagnostic groups.
Highlights
Most studies on health-related quality of life (HRQOL) in children with cancer focussed on survivors
While survival rates and health status are fairly easy to assess, they often do not appropriately mirror the entire impact of the cancer and its treatment on the individual child, with respect to subjective experiences. Such consequences of disease and treatment can be tapped by measures of health-related quality of life (HRQOL)
A few studies have been conducted with pediatric cancer patients during the acute phase of the disease, i.e., during ongoing oncological treatment
Summary
Most studies on health-related quality of life (HRQOL) in children with cancer focussed on survivors. There has been a dramatic improvement in long-term survival of childhood cancer patients during the past decades This is related to new approaches to treatment, centralization of care, improved supportive care, and the development of large international clinical trials. While survival rates and health status are fairly easy to assess, they often do not appropriately mirror the entire impact of the cancer and its treatment on the individual child, with respect to subjective experiences. Such consequences of disease and treatment can be tapped by measures of health-related quality of life (HRQOL). HRQOL is usually assessed by patients' self report or by parental proxy report
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