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（通过应用程序证明）：儿童癌症幸存者容易受到信任相关的后期效应，其中包括PSYC骨骼病态，并且在儿童癌症幸存者中，炎性状态是常见的迟到。据报道，尚不确定个人症状是否会随着时间的流逝而变化，以及与不良症状相关的单个症状结构域和簇的变化，包括慢性病和过早死亡率。 随着时间的流逝，个体症状和症状的变化。 1）为了调查跨越童年成人幸存者25年的多个时间点的个人症状领域，抑郁症和症状簇，并随着时间的推移而转移症状簇的转移，2）研究单个症状领域的预后价值症状和慢性疾病的发育和儿童癌症的成年幸存者的发展与H症状进度相关。基于T.裘德寿命队列研究的全面评估（n> 700）我们将通过八个器官系统进行慢性条件：心血管，内分泌/繁殖，肝，神经认知，神经感觉，神经感觉，骨骼，肺部，肺和泌尿类别。开发一种基于八个个体症状领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群的变化。科学研究。