Calaminus G, Weinspach S, Teske C, Göbel U
Clinic for Pediatric Oncology, Hematology and Clinical Immunology, Children's Hospital, Universitätsklinikum Düsseldorf, Heinrich-Heine-University, Moorenstrasse 5, 40225 Düsseldorf.
Klin Padiatr. 2007 May-Jun;219(3):152-7. doi: 10.1055/s-2007-973846.
Considering the high survival rates of childhood cancer physical and psychosocial long term effects (LF) as well as the estimation of Quality of Life (QoL) are becoming a new focus of clinical research. Thus, disease related as well as age related variables have to be taken into account. This paper evaluates the physical long term effects of childhood cancer survivors. In addition differences of QoL of the survivors in comparison to children and adolescents of the same age are estimated if present and correlated to somatic late effects.
36 survivors of childhood cancer who are followed at the University Children's Hospital Duesseldorf, with an age range of 8-18 years participate in the evaluation. Together with a clinical examination somatic long term effects and sociodemographic information are documented. QoL is evaluated with a standardized questionnaire (PEDQOL) including the domains physical function, emotion, cognition, autonomy, social function (family, friends and body image). Quality of Life data are compared with data of 319 unselected healthy controls of comparable age groups.
24 of 36 patients show various LF: skeletal deformities, scars, impairment of organ function, infectious complication, hormonal failures. Patients with solid tumors develop more and more frequently severe LF (11/14 pat.) compared to patients with leukaemia and lymphoma (11/22 pat.). Nevertheless health status can be objectively rated as satisfying in comparison to children of the same age. Most patients rate the QoL better than their controls. Patients with severe LF show impairment in the domains body image, emotional and physical functioning and cognition compared to patients without or with minor somatic LF.
Our results underline the influence of objective long term effects and subjective QoL on the Quality of Survival. Prospective evaluation will lead to new and important information with respect to the onset of somatic and psychosocial LF and possible coping strategies. These information will establish additional possibilities for initiation of primary and secondary rehabilitation processes.
鉴于儿童癌症患者的高生存率，其身体和心理社会长期影响以及生活质量（QoL）评估正成为临床研究的新焦点。因此，必须考虑与疾病相关以及与年龄相关的变量。本文评估了儿童癌症幸存者的身体长期影响。此外，还评估了幸存者与同年龄儿童和青少年相比的生活质量差异（如有），并将其与躯体迟发效应相关联。
36名在杜塞尔多夫大学儿童医院接受随访的儿童癌症幸存者参与了评估，年龄范围为8至18岁。除临床检查外，还记录了躯体长期影响和社会人口统计学信息。使用标准化问卷（PEDQOL）评估生活质量，该问卷包括身体功能、情绪、认知、自主性、社会功能（家庭、朋友和身体形象）等领域。将生活质量数据与319名未挑选的、年龄相当的健康对照的数据进行比较。
36名患者中有24名表现出各种长期影响：骨骼畸形、疤痕、器官功能损害、感染并发症、激素功能障碍。与白血病和淋巴瘤患者（11/22例）相比，实体瘤患者出现严重长期影响的频率越来越高（11/14例）。然而，与同年龄儿童相比，健康状况在客观上可评为令人满意。大多数患者对生活质量的评分高于其对照。与无或有轻微躯体长期影响的患者相比，有严重长期影响的患者在身体形象、情绪和身体功能以及认知领域存在损害。
我们的结果强调了客观长期影响和主观生活质量对生存质量的影响。前瞻性评估将产生关于躯体和心理社会长期影响的发生以及可能应对策略的新的重要信息。这些信息将为启动一级和二级康复过程提供更多可能性。
