Erice Statement on Survivorship Updated

It’s hard to believe it’s been over 10 years since the first Erice statement in 2016, which laid out 10 key points summarising the essential components of cure and care for childhood cancer survivors!

In Nov 2016, 65 pediatric cancer experts from 17 European countries and North America, including many members of the PanCareLIFE team, met in Erice as part of the semi-annual PanCare meeting to review the original statement. They have now published an updated version of the statement in the Journal of Cancer Survivorship (https://doi.org/10.1007/s11764-018-0701-0).

 

Influence of genetic variation on late toxicities in childhood cancer survivors

Check out our latest open access publication in Critical Reviews in Oncology/Hematology!

PanCareLIFE features in FNM Newsletter

The March edition of the FNM newsletter includes a feature on PanCareLIFE. The article describes how the paradigm in childhood oncology has changed from acute care to cure cancer to chronic care, where there is a focus on cure but also on prevention of late effects and their lifelong, informed management. Lifelong management relies on systematic research in late effects, like that conducted in PanCareLIFE, as well as sophisticated systems of care transition for adult survivors and empowering survivors to co-manage their own care through initiatives like Together to Smile in the Czech Republic.

You can read more in Czech here.

New publication from our sister project PanCareSurFup

Check out the latest open access publication from our sister project PanCareSurFup in the European Journal of Epidemiology!

 

 

Audiological monitoring in Swiss childhood cancer patients

PanCareLIFE researchers at UNIBE have just published a new paper ‘Audiological monitoring in Swiss childhood cancer patients’, funded in part by PanCareLIFE.

Pediatric Blood & Cancer, 65(3) e26877, DOI: 10.1080/08880018.2017.1323985

Abstract

Background

Full audiological monitoring is the best strategy to detect hearing loss early and to provide timely intervention in the absence of a clinical method of otoprotection. Full monitoring requires audiological evaluation before, and then during and after ototoxic cancer treatment. In a worldwide context of monitoring protocols that vary substantially, we analyzed the audiological monitoring of childhood cancer patients over the last decade across treatment centers in Switzerland.

Procedure

We retrospectively searched for audiological evaluations in all nine Swiss Pediatric Oncology Centers. We analyzed proportions of patients who had audiological monitoring and described type and timing of monitoring. We determined predictors of audiological monitoring using multivariable logistic regression and described time trends.

Results

We included 185 patients from the Swiss Childhood Cancer Registry diagnosed from 2005 to 2013 who had platinum chemotherapy and/or cranial radiation ≥30 Gray and who were alive at time of study. Less than half of children, 43%, had full audiological monitoring (before, during, and after treatment), while 72% were tested after cancer treatment. Nonstudy patients were less likely to have had monitoring in all phases of cancer treatment. Patients who received treatment with cisplatin or both platinum chemotherapy and cranial radiation were more likely to have had monitoring after treatment. Monitoring during and after treatment increased over the study period, but monitoring before treatment was insufficient in all time periods.

Conclusions

Our population-based study indicates that audiological monitoring is insufficient in Switzerland, particularly for nonstudy patients. Clinicians must become more aware of the importance of full audiological monitoring.

Related Publication: Audiological monitoring in Swiss childhood cancer patients

PanCareLIFE partners at UNIBE have published the results of their work on ‘Audiological monitoring in Swiss childhood cancer patients’ in Pediatric Blood & Cancer (A. Weiss et al. 2017;e26877, https://doi.org/10.1002/pbc.26877).

Abstract Background: Full audiological monitoring is the best strategy to detect hearing loss early and to provide timely intervention in the absence of a clinical method of otoprotection. Full monitoring requires audiological evaluation before, and then during and after ototoxic cancer treatment. In a worldwide context of monitoring protocols that vary substantially, we analyzed the audiological monitoring of childhood cancer patients over the last decade across treatment centers in Switzerland.

Procedure: We retrospectively searched for audiological evaluations in all nine Swiss Pediatric Oncology Centers. We analyzed proportions of patients who had audiological monitoring and described type and timing of monitoring. We determined predictors of audiological monitoring using multivariable logistic regression and described time trends.

Results: We included 185 patients from the Swiss Childhood Cancer Registry diagnosed from 2005 to 2013 who had platinum chemotherapy and/or cranial radiation ≥30 Gray and who were alive at time of study. Less than half of children, 43%, had full audiological monitoring (before, during, and after treatment), while 72% were tested after cancer treatment. Nonstudy patients were less likely to have had monitoring in all phases of cancer treatment. Patients who received treatment with cisplatin or both platinum chemotherapy and cranial radiation were more likely to have had monitoring after treatment. Monitoring during and after treatment increased over the study period, but monitoring before treatment was insufficient in all time periods.

Conclusions: Our population-based study indicates that audiological monitoring is insufficient in Switzerland, particularly for nonstudy patients. Clinicians must become more aware of the importance of full audiological monitoring.

Socio-demographic impact of platinum-induced ototoxicity in long-term survivors of childhood cancer

PanCareLIFE researchers from EMC and PMC have published ‘Socio-demographic impact of platinum-induced ototoxicity in long-term survivors of childhood cancer’ (Curr Pediatr Res 2017; 21 (3): 470-479).

You can read the full open access publication here.

Objective: Childhood cancer survivors (CCS) treated with platinum-based chemotherapy are at risk of treatment-induced ototoxicity. To date, there is limited knowledge on the effect of ototoxicity on socio-demographic factors, the burden to obtain insurances and psychological distress in CCS.

Design: Of the 653 CCS with completed questionnaires, 54 survivors had been treated with platinum. Ototoxicity (Münster score ≥ 2b) data were retrieved from pure-tone audiometry. All survivors completed a questionnaire consisting of the Distress Thermometer (DT), measuring the severity of distress and was recoded to a 0 (no distress)-10 (extreme distress) scale. The Hospital Anxiety and Depression Scale (HADS) was used to study the psychological distress (a score ≥ 15 is indicative for clinically significant distress).

Results: Median age at diagnosis was 6.2 years (range: 0.01-17.8) and median follow-up time from end of treatment to questionnaire was 15.6 years (range: 3.2-43.7). There were no differences in attempts to obtain insurances, highest education achievement and (un) employment between platinum-treated survivors and non-platinum treated survivors. Among the 54 platinum-treated CCS, median HADS score of hearing impaired survivors (n=22 (median score: 4.5, range: 0.0-29)) was not significantly different from survivors without ototoxicity (n=32 (median score 5.5, range: 0.0-11, p=0.337)). Similarly, DT scores were not significantly different between survivors with or without ototoxicity (p=0.441). Compared to the 599 non-platinum treated survivors, median HADS and DT scores of platinum-treated survivors were not significantly different.

Conclusion: Based on this first, small study, we didn’t find differences between CCS who suffer from platinum-related ototoxicity and survivors without hearing impairment, suggesting that CCS with ototoxicity do not necessarily encounter more socio-demographic challenges and psychological distress than CCS without ototoxicity.

Hearing loss after platinum treatment is irreversible in non-cranial irradiated childhood cancer survivors

PanCareLIFE researchers at EMC, VUmc, AMC, PMC and UKM have just published a new paper ‘Hearing loss after platinum treatment is irreversible in noncranial irradiated childhood cancer survivors’, funded in part by PanCareLIFE.

Pediatric Hematology and Oncology, 34:2, 120-129, DOI: 10.1080/08880018.2017.1323985

You can read the full, open access article here.

Validation of questionnaire-reported hearing with medical records: A report from the Swiss Childhood Cancer Survivor Study

PanCareLIFE researchers at the University of Bern have just published a new paper ‘Validation of questionnaire-reported hearing with medical records: A report from the Swiss Childhood Cancer Survivor Study’, funded in part by PanCareLIFE. You can read the full, open access article here.

Related Publication: Long-term auditory complications after childhood cancer: A report from the Swiss Childhood Cancer Survivor Study

PanCareLIFE partners at UNIBE have published the results of their work on ‘Long-term auditory complications after childhood cancer: A report from the Swiss Childhood Cancer Survivor Study’ in Pediatric Blood & Cancer (A. Weiss et al. 2017 Feb;64(2):364-373. doi: 10.1002/pbc.26212).

BACKGROUND:

Auditory complications are an adverse event of childhood cancer treatment, especially common in children treated with platinum chemotherapy or cranial radiation. Variation between diagnostic childhood cancer groups has rarely been studied, and we do not know if the burden of auditory complications has changed over the last decades.

PROCEDURE:

Within the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to all survivors who were diagnosed at age 16 years or less between 1976 and 2005. We compared prevalence of self-reported hearing loss and tinnitus between all diagnostic childhood cancer groups and siblings, used multivariable logistic regression to analyze the effect of treatment-related factors on hearing loss, and compared the cumulative incidence of hearing loss between different periods of cancer diagnosis.

RESULTS:

Prevalence of self-reported hearing loss was higher in survivors (10%) than in siblings (3%, P < 0.001), and highest in survivors of central nervous system tumors (25%). Significant risk factors were treatment with platinum compounds (carboplatin: odds ratio [OR] 2.4; cisplatin: OR 9.4), cranial radiation (>29 Gy: OR >1.7), or brain surgery (OR 2.2). Children diagnosed in 1986-1995, when platinum compounds came into widespread use, had a significantly higher cumulative incidence of hearing loss than those diagnosed in 1976-1985. In the most recent period, 1996-2005, the risk decreased again, both for patients treated with platinum compounds and with cranial radiation.

CONCLUSIONS:

Our data show that the burden of hearing loss has stabilized in recently treated survivors, suggesting that survivors have benefited from new treatment regimens that use less ototoxic radiation and more carefully dosed platinum compounds.