Check out our latest open access publication in Critical Reviews in Oncology/Hematology!
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.
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
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.
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.
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.
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.
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.
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.
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.
PanCareLIFE researchers at EMC, VUmc, AMC, PMC and UKM have published ‘Determinants of ototoxicity in 451 platinum-treated Dutch survivors of childhood cancer: A DCOG late-effects study’, funded in part by PanCareLIFE.
European Journal of Cancer (2016) 69: 77, DOI: 10.1016/j.ejca.2016.09.023
PanCareLIFE researchers from EMC and VUmc have published ‘Longitudinal follow-up in female Childhood Cancer Survivors: no signs of accelerated ovarian function loss’ (Human Reproduction, Vol.32, No.1 pp. 193–200, 2017).
You can read the full open access publication here.
STUDY QUESTION: Is the long-term decline of ovarian function, as reflected by a decrease in serum anti-Müllerian hormone (AMH) concentration, accelerated over time in female childhood cancer survivors (CCS) as compared to healthy women of the same age?
SUMMARY ANSWER: The median decline of AMH levels in long-term female CCS is not accelerated and similar to that observed in healthy controls.
WHAT IS KNOWN ALREADY: Gonadal function is compromised in female CCS treated with chemotherapy and/or radiation therapy. Ovarian function is most compromised in survivors treated with total body irradiation, abdominal or pelvic irradiation, stem cell transplantation or high doses of alkylating agents.
STUDY DESIGN SIZE, DURATION: Longitudinal single-centre cohort study in 192 CCS in Rotterdam, The Netherlands, between 2001 and 2014.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Serum AMH levels of 192 adult female CCS were assessed, at least five years after cessation of treatment and at a follow-up visit with a median of 3.2 years (range: 2.1–6.0) later and were compared to the age-based P50 of AMH in healthy controls.
MAIN RESULTS AND THE ROLE OF CHANCE: Median AMH levels were below the P50 at both visit 1 (−0.59 µg/L) and at visit 2 (−0.22 µg/L). In women with a sustained ovarian function (AMH > 1.0 µg/L), the decline in AMH is similar to that in the normal population (difference in decline per year: −0.07 µg/L (range: −2.86 to 4.92), P = 0.75). None of the treatment modalities was correlated with a signifi- cant acceleration of decline of AMH per year.
LIMITATIONS REASONS FOR CAUTION: We selected CCS that visited our late effect outpatient clinic and who had two AMH levels available. It is conceivable that women without any apparent late effects of treatment as well as women with extreme late effects, which might be the ones with the largest impact on ovarian function, could be more likely to be lost to follow-up. However, general characteristics did not differ between the included and excluded patients.
WIDER IMPLICATIONS OF THE FINDINGS: While prospective longitudinal research is required to strengthen our findings, they may help physicians to counsel female CCS about their expected reproductive lifespan.
Our Danish colleagues from KB are co-authors on the publication ‘Gastrointestinal and liver disease in Adult Life After Childhood Cancer in Scandinavia: A population-based cohort study’ in the International Journal of Cancer.
This project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no 602030. The material presented and views expressed here are the responsibility of the author(s) only. The EU Commission takes no responsibility for any use made of the information set out.