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Symptom Adverse Events and Quality of Life of Children With Advanced Cancer: Results From a Longitudinal Study Using
Krista Grinde1, Jennifer L Raybin2, Jessica Ward3
1University of Wisconsin-Madison School of Medicine and Public Health, WI, USA.
Insights
Poorly controlled symptoms like anxiety and nausea significantly reduce quality of life (QoL) in children with advanced cancer. These symptom adverse events (AEs) negatively correlate with overall QoL during treatment.
Area of Science:
- Pediatric Oncology
- Clinical Nursing
- Patient-Reported Outcomes
Background:
- Poorly controlled symptoms significantly impair quality of life (QoL) in pediatric cancer patients during treatment.
- Understanding the link between symptom adverse events (AEs) and QoL is crucial for improving patient care.
Purpose of the Study:
- To explore the relationship between QoL and symptom AEs in children with advanced cancer over a 6-month period.
- To identify specific symptoms that most strongly impact QoL in this population.
Main Methods:
- A prospective, longitudinal descriptive study involving 49 children (aged 2-18) with advanced cancer.
- Quality of life assessed using the Pediatric Quality of Life Inventory (PedsQL™) Cancer Module 3.0.
- Symptom adverse events measured via the Pediatric Patient-Reported Outcome-Common Terminology Criteria for AEs (PRO-CTCAEs®).
Main Results:
- Children with central nervous system (CNS) tumors reported lower QoL than those with hematologic or non-CNS solid tumors.
- Anxiety, pain, nausea, insomnia, hot flashes, and fatigue severity showed the strongest negative correlation with total QoL scores.
- Nausea and anxiety frequency AEs were associated with poorer QoL at week 8.
Conclusions:
- The study validates the use of PRO-CTCAE® and PedsQL™ for assessing symptom AEs and QoL in pediatric cancer research.
- Identifying and managing key symptom AEs is vital for enhancing QoL in children undergoing cancer treatment.
Abstract:
Background: The presence of poorly controlled symptoms negatively impacts the quality of life (QoL) throughout cancer treatment. The purpose of this multisite study was to explore the relationship between QoL and symptom adverse events (AEs) in children with advanced cancer over 6 months. Method: A prospective and longitudinal descriptive study design was used to collect QoL and symptom AE data from children aged 2 to 18 with advanced cancer. QoL was measured using the Pediatric Quality of Life Inventory (PedsQLTM) Cancer Module 3.0 and symptom AEs were measured using the Pediatric Patient-Reported Outcome-Common Terminology Criteria for AEs (PRO-CTCAEs®). Descriptive statistics were used to describe QoL and symptom AE data. Correlational analyses and generalized linear mixed models were used to examine the relationship between symptom AEs and QoL. Results: Forty-nine children participated in the study. The mean total PedsQLTM score was 73.86 for the sample across all time points. Children diagnosed with a central nervous system (CNS) tumor reported poorer QoL compared to children diagnosed with a hematologic malignancy or non-CNS solid tumor. Symptom frequency AEs of anxiety, pain, nausea, insomnia, hot flashes, and fatigue severity demonstrated the strongest and most significant negative correlation with total QoL scores. Analyses of the relationship between QoL and symptom AEs over time revealed time-specific significant differences with children who experienced frequency AEs of nausea, and anxiety reporting poorer QoL at time point 4 (week 8). Discussion: The Ped PRO-CTCAE® and PedsQLTM can be used to evaluate the relationship between symptom AEs and QoL in practice and in future research.
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