Langeveld N E, Stam H, Grootenhuis M A, Last B F
Department of Paediatric Oncology, Emma Kinderziekenhuis, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Support Care Cancer. 2002 Nov;10(8):579-600. doi: 10.1007/s00520-002-0388-6. Epub 2002 Oct 24.
In recent years the necessity of measuring quality of life in childhood cancer survivors has been stressed. This paper gives an overview of the results of studies into the quality of life (QL) of young adult survivors of childhood cancer and suggest areas for future research. The review located 30 empirical studies published up to 2001. The results are described in terms of the following QL dimensions: physical functioning (QL, general health), psychological functioning (overall emotional functioning, depression and anxiety, self-esteem), social functioning (education, employment, insurance, living situation, marital status and family), and sexual functioning. Factors related to survivors' QL are reported: demographics and illness- and treatment related variables. Although the literature yields some inconsistent findings, a number of clear trends can be identified: (a) most survivors reported being in good health, with the exception of some bone tumour survivors; (b) most survivors function well psychologically; (c) survivors of CNS tumours and survivors of acute lymphoblastic leukaemia (ALL) are at risk for educational deficits; (d) job discrimination, difficulties in obtaining work and problems in obtaining health and life insurance were reported; (e) survivors have lower rates of marriage and parenthood; (f) survivors worry about their reproductive capacity and/or about future health problems their children might experience as a result of their cancer history. There is a need for methodological studies that measure QL among survivors of childhood cancer more precisely by taking into account the effects of the severity of the cancer and the long-term impact of different treatments. Additional data are needed to help us understand the needs of survivors and to identify those subgroups of survivors who are at greatest risk for the adverse sequelae of the disease and its treatment.
近年来，人们强调了测量儿童癌症幸存者生活质量的必要性。本文概述了对儿童癌症年轻成年幸存者生活质量（QL）的研究结果，并提出了未来研究的方向。该综述检索了截至2001年发表的30项实证研究。结果按照以下生活质量维度进行描述：身体功能（生活质量、总体健康状况）、心理功能（总体情绪功能、抑郁和焦虑、自尊）、社会功能（教育、就业、保险、生活状况、婚姻状况和家庭）以及性功能。报告了与幸存者生活质量相关的因素：人口统计学因素以及与疾病和治疗相关的变量。尽管文献中有一些不一致的发现，但仍可确定一些明显的趋势：（a）除了一些骨肿瘤幸存者外，大多数幸存者报告健康状况良好；（b）大多数幸存者心理功能良好；（c）中枢神经系统肿瘤幸存者和急性淋巴细胞白血病（ALL）幸存者存在教育缺陷风险；（d）报告了工作歧视、就业困难以及获得健康和人寿保险方面的问题；（e）幸存者的结婚率和生育率较低；（f）幸存者担心自己的生殖能力和/或担心其子女由于他们的癌症病史可能会经历的未来健康问题。需要开展方法学研究，通过考虑癌症严重程度的影响和不同治疗的长期影响，更精确地测量儿童癌症幸存者的生活质量。还需要更多数据来帮助我们了解幸存者的需求，并确定那些在疾病及其治疗的不良后遗症方面风险最大的幸存者亚组。
