Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA,
J Cancer Surviv. 2013 Dec;7(4):523-34. doi: 10.1007/s11764-013-0289-3. Epub 2013 Jun 8.
Childhood cancer survivors (CCSs) are at increased risk for poor health-related quality of life (HRQOL) and chronic health conditions-both of which can be exacerbated by unhealthy lifestyle behaviors. Developing a clearer understanding of the associations between HRQOL, lifestyle behaviors, and medical and demographic variables (e.g., age/developmental stage at time of diagnosis) is an important step toward developing more targeted behavioral interventions for this population.
Cross-sectional questionnaires were completed by 170 CCSs who were diagnosed with leukemia, lymphoma, sarcoma, or a cancer of the central nervous system (CNS) and treated at a comprehensive cancer center between 1992 and 2007. Questionnaires addressed weight status, lifestyle behaviors, aspects of HRQOL, and intervention preferences.
Adolescent and young adult survivors (AYAs) and survivors of CNS tumors or lymphoma reported significantly (p < .05) poorer HRQOL across multiple domains compared to those diagnosed at an earlier age, survivors of leukemia or sarcoma, and healthy populations. A significant proportion also failed to meet national recommendations for dietary intakes (39-94 %) and physical activity (65 %). Female survivors reported poorer physical functioning and consumed less dietary fiber and fruits and vegetables than did male survivors. They also expressed the strongest interest in participating in diet and exercise interventions.
Findings support the premise that females, AYAs, and survivors of cancers of the CNS or lymphoma are "at risk" subgroups within the CCS population for poor dietary practices, sedentary behaviors, and poor HRQOL. Future research should focus on developing diet and PA interventions to improve HRQOL that target these groups.
Greater consideration of the role of gender, developmental stage, and the HRQOL challenges facing CCSs may help researchers to develop targeted behavioral interventions for those who stand to benefit the most.
儿童癌症幸存者（CCS）面临健康相关生活质量（HRQOL）下降和慢性健康状况的风险增加-这两者都可能因不健康的生活方式行为而加剧。更清楚地了解 HRQOL、生活方式行为以及医疗和人口统计学变量（例如，诊断时的年龄/发育阶段）之间的关联，是为该人群开发更具针对性的行为干预措施的重要步骤。
1992 年至 2007 年间，在综合癌症中心接受治疗的患有白血病、淋巴瘤、肉瘤或中枢神经系统（CNS）癌症的 170 名 CCS 完成了横断面问卷。问卷涉及体重状况、生活方式行为、HRQOL 方面以及干预措施偏好。
与更早诊断的患者相比，青少年和年轻成人幸存者（AYAs）以及 CNS 肿瘤或淋巴瘤幸存者在多个领域的 HRQOL 明显较差（p <.05），他们还发现与白血病或肉瘤幸存者和健康人群相比，他们不符合国家饮食摄入量（39-94％）和体力活动（65％）的建议。很大一部分人也未能达到国家推荐的饮食摄入量（39-94%）和体力活动量（65%）。女性幸存者报告的身体机能较差，膳食纤维、水果和蔬菜的摄入量也少于男性幸存者。他们还表示对参加饮食和运动干预最感兴趣。
研究结果支持这样的前提，即女性、AYAs 以及 CNS 或淋巴瘤癌症幸存者是 CCS 人群中“处于危险中”的亚组，他们的不良饮食行为、久坐行为和较差的 HRQOL。未来的研究应侧重于开发针对这些群体的饮食和 PA 干预措施，以改善 HRQOL。
更多地考虑性别、发育阶段以及 CCS 面临的 HRQOL 挑战，可能有助于研究人员为那些最受益的人开发有针对性的行为干预措施。
