Thames Valley Children's Centre, 779 Base Line Road East, London, Ontario, Canada.
Support Care Cancer. 2009 Oct;17(10):1231-46. doi: 10.1007/s00520-009-0660-0. Epub 2009 Jun 2.
The purpose of this paper was to provide a comprehensive, contemporary systematic review of studies that have examined the quality of life (QOL) of survivors of childhood cancer in order to extend upon the findings of earlier reviews.
A review was conducted that used the databases MEDLINE, PubMed, PsycINFO, and CINAHL. Articles were included that were published in English between 2001 and 2008 and used quantitative measures and statistical tests to compare health-related quality of life (HRQL) or QOL of childhood cancer survivors with population norms or matched comparison groups.
Thirteen studies were identified. Findings were contradictory across studies, yet by and large, reflected those of past reviews. In general, survivors' scores on subscales representing physical, psychological, and social domains of HRQL/QOL were similar to comparisons, with the greatest differences being in physical well-being. Key personal and environmental factors were negatively correlated with the three domains across studies for survivors including: older age at diagnosis, longer time since diagnosis, certain cancer and treatment types, female gender, and a number of socioeconomic factors.
Lack of comparability across studies remains a problem due to wide variation in study focus and designs. Conceptual and methodological issues include: use of numerous HRQOL and QOL measures, lack of distinction between conceptualization and measurement of HRQL and QOL, lack of initial qualitative input from survivors about QOL, little examination of the influence of environmental factors on QOL, little attention to survivors' satisfaction with life quality, use of small heterogeneous samples, and need for population-based longitudinal studies.
本文旨在对已研究的儿童癌症幸存者生活质量（QOL）的文献进行全面、当代的系统回顾，以便进一步扩展早期综述的发现。
我们进行了一次文献回顾，使用了 MEDLINE、PubMed、PsycINFO 和 CINAHL 数据库。我们纳入了发表于 2001 年至 2008 年间的英文文章，这些文章使用了定量测量和统计检验来比较儿童癌症幸存者的健康相关生活质量（HRQL）或 QOL 与人群正常值或匹配的对照组。
共确定了 13 项研究。研究结果相互矛盾，但总体上反映了过去的综述结果。一般来说，幸存者在代表 HRQL/QOL 的身体、心理和社会领域的子量表上的得分与比较结果相似，最大的差异在于身体幸福感。关键的个人和环境因素与研究中所有幸存者的三个领域呈负相关，包括：诊断时年龄较大、诊断后时间较长、某些癌症和治疗类型、女性性别以及一些社会经济因素。
由于研究重点和设计的广泛差异，研究之间的可比性仍然是一个问题。概念和方法问题包括：使用了许多 HRQOL 和 QOL 测量方法、缺乏对 HRQL 和 QOL 的概念化和测量的区分、缺乏幸存者对 QOL 的初步定性投入、对环境因素对 QOL 的影响的研究较少、对幸存者对生活质量的满意度关注较少、使用小的异质样本以及需要基于人群的纵向研究。
