Patient-reported health status during pediatric cancer treatment

Changes in patient function and factors affecting pediatric patients with cancer during treatment are largely unknown. The purpose of this study was to measure patient-reported outcomes (PROs) in children during the initial 6 months of therapy to characterize function and explore factors associated with function including type of cancer, intensity of therapy, age, and gender.

We conducted a prospective cohort study of children aged 5-21 newly diagnosed with cancer. PROs were obtained twice monthly over the first 6 months of treatment. The Patient-Reported Outcome Measurement Information System (PROMIS) was used to measure patient mobility, fatigue, pain interference, peer relationships, anxiety, and depressive symptoms. A generalized linear mixed model was used to analyze changes by domain over time.

Forty patients completed the study with a mean age of 11.7 years (standard deviation [SD] 4.7), 60% had leukemia/lymphoma. All patients report improved pain over time (P = 0.008). Patients with central nervous system (CNS)/solid tumor report better mobility (P < 0.001), less fatigue (P < 0.001), less pain (P < 0.001), less anxiety (P < 0.001), fewer depressive symptoms (P < 0.001), and better peer relationships (P = 0.0036). Younger patients report worse mobility (P = 0.017), more fatigue (P = 0.032), more pain (P < 0.001), more anxiety (P = 0.017), and more depressive symptoms (P = 0.005).

Pain improved for all patients over the first 6 months of cancer treatment. Age and tumor type also affected patient-reported function for all domains. Understanding the burden of cancer treatment is critical to refine supportive care interventions to minimize the burden of pediatric cancer treatment.