Symptom progress and adverse health outcomes in adult childhood cancer survivors

成年儿童癌症幸存者的症状进展和不良健康结果

• 批准号: 9024265
• 负责人: I-Chan Huang
• 金额: $ 23.31万
• 依托单位: ST. JUDE CHILDREN'S RESEARCH HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-12-01 至 2017-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9024265
• 关键词: Address; Adult; Affect; Age; Alkylating Agents; Anthracyclines; Anxiety; Back; Cancer Patient; Cancer Survivor; Cancer Survivorship; Cardiac; Cardiovascular system; Caring; Categories; Cessation of life; Child Psychology; Childhood Cancer Survivor Study; Chronic; Classification; Cohort Studies; Cranial Irradiation; Data; Development; Diagnosis; Emotional; Endocrine; Enrollment; Esthesia; Event; Foundations; Future; Goals; Head; Head and neck structure; Health; Heart Arrest; Hepatic; Incidence; Individual; Intervention; Knowledge; Late Effects; Lead; Life; Lung; Malignant Childhood Neoplasm; Malignant Neoplasms; Measurement; Medical; Mental Depression; Methodology; Methods; Morbidity - disease rate; Motor; Movement; Nature; Neck; Neurocognitive; Operative Surgical Procedures; Outcome; Pain; Participant; Patient Outcomes Assessments; Patient Self-Report; Play; Premature Mortality; Prevalence; Psychophysiologic Disorders; Quality of life; Radiation therapy; Reporting; Research; Research Personnel; Respiratory Signs and Symptoms; Risk; Role; Saint Jude Children' s Research Hospital; Sentinel; Severities; Siblings; Site; Survival Rate; Survivors; Symptoms; Therapeutic; Time; Translational Research; adverse outcome; associated symptom; base; cancer diagnosis; cancer therapy; chemotherapy; childhood cancer survivor; cohort; design; experience; follow-up; healthy aging; high risk; improved; mortality; neurosensory; persistent symptom; premature; prevent; prognostic value; psychosocial; public health relevance; reproductive; screening; skeletal; success; survivorship; symptom cluster; therapy design; urinary

 DESCRIPTION (provided by applicant): Childhood cancer survivors are vulnerable to treatment-related late effects, which include physical and psychosocial morbidity, subsequent malignancies, and premature death. Symptoms representing one's perceptive abnormal physical, emotional, or psychosomatic state are common late effects in childhood cancer survivors. Survivors often experience multiple, concurrent symptoms, known as a symptom cluster. Although the association between symptom presence and poor quality of life in childhood cancer survivors has been reported, it is uncertain whether individual symptom domains and clusters change over time, and whether the change in individual symptom domains and clusters are associated with adverse health outcomes, including chronic conditions and premature mortality. In addition, very few studies have examined if specific cancer therapeutic exposures (e.g., cranial irradiation, anthracyclines, and alkylating agents) contribute to the change in individual symptoms and symptom clusters over time. Our long-term goal of cancer survivorship care is to identify important symptoms for early indication of adverse health events (e.g., cardiac arrest and premature mortality), and to design interventions targeting at symptoms for promotion of healthy aging in cancer survivors. To achieve this goal, the current study proposes two specific aims: 1) to investigate the presence of individual symptom domains (sensation abnormality, motor/movement problems, cardiac symptoms, pulmonary symptom, pain, anxiety, depression, and somatization) and symptom clusters across multiple time points spanning 25 years in adult survivors of childhood cancers, and investigate the transition of symptom clusters over time, and 2) to investigate the prognostic value of individual symptom domains and symptom clusters for the development of chronic conditions and premature mortality in adult survivors of childhood cancers. The proposed study will overcome the limitations of previous research by utilizing repeated symptom data collected from participants in the Childhood Cancer Survivor Study to elucidate the extent to which symptom progress is associated with mortality and with chronic conditions identified during risk-based comprehensive medical assessment in the St. Jude Lifetime Cohort Study (N>700) at St. Jude Children's Research Hospital. We will group chronic conditions by eight organ systems: cardiovascular, endocrine/reproductive, hepatic, neurocognitive, neurosensory, skeletal, pulmonary, and urinary categories. In addition, we will develop a classification methodology to identify symptom clusters based on eight individual symptom domains, and use a transition analytic method to capture the change in symptom cluster over time. Our team includes renowned researchers with expertise in patient-reported outcomes, symptom measurement, psychology, pediatric/adult survivorship care, and translational science research.

 描述（由适用提供）：儿童癌症的存活很容易受到与治疗相关的后期作用的影响，其中包括身体和社会心理发病率，随后的恶性肿瘤和过早死亡。代表一个人的感知异常，情感或心身状态的症状是儿童癌症存活中常见的后期影响。幸存者经常经历多种并发症状，称为症状簇。尽管已经报道了症状存在与儿童癌症生存质量差之间的关联，但尚不确定个人症状域和簇是否会随着时间的流逝而变化，以及个体症状域和簇的变化是否与不良健康结果有关，包括慢性病和早期死亡率。此外，很少有研究检查特定的癌症治疗性暴露（例如颅辐照，蒽环类药物和藻类剂）是否有助于 随着时间的流逝，各个症状和症状簇的变化。我们的长期癌症生存护理目标是确定重要的症状，以表明早期迹象的不良健康事件（例如心脏骤停和早死亡），并设计针对症状的干预措施以促进癌症生存中健康衰老的症状。 To achieve this goal, the current study proposals two specific aims: 1) to investigate the presence of individual symptom domains (sensation) abnormality, motor/movement problems, cardiac symptoms, pulmonary symptom, pain, anxiety, depression, and somatization) and symptom clusters across multiple time points spanning 25 years in adult survivals of childhood cancers, and investigate the transition of symptom clusters over time, and 2) to investigate the prognostic value of individual症状结构群和症状群，用于慢性病的发展和儿童癌症成人生存期间的早死亡。拟议的研究将通过利用从儿童期癌症幸存者研究中收集的反复症状数据来克服先前研究的局限性，以阐明症状进展与死亡率有关的程度以及与圣犹大犹太儿童研究医院的St. Jude-lifetime Corhort研究（n> 700）中基于风险的基于风险的综合医疗评估中确定的慢性病有关的程度。我们将通过八个器官系统进行慢性病：心血管，内分泌/生殖，肝炎，神经认知，神经感觉，骨骼，肺部和泌尿类别。此外，我们将开发一种基于八个个体症状结构域的症状簇来识别症状簇，并使用过渡分析方法随着时间的推移捕获症状簇的变化。我们的团队包括拥有患者报告结果，症状测量，心理学，儿科/成人表面护理和转化科学研究方面的专业知识的知名研究人员。