Abstract

Survival itself has, until recently, been the marker of successful cancer therapy, but now more attention is being focused on the long-term effects of cancer therapy and the quality of life (QOL)of the survivors.

OBJECTIVE: To assess health related quality of life and behavior and emotional problems among childhood cancer survivors at Ain Shams Pediatric Oncology Clinic, Cairo, Egypt.

DESIGN: This study was conducted on 30 childhood cancer survivors attending the cancer survivors’ clinic at Ain Sham Children’s University Hospital in the period of October 2004–April 2005. The PedsQL™ 4.0 Generic Core Scales (physical, emotional, social and, school functioning) translated into Arabic language has been utilized. Parallel child self-report and parent proxy-report questionnaire formats have been used. Items were reverse-scored and linearly transformed to a 0–100 scale, so that higher scores indicate better QOL. Assessment of behavioral and emotional disturbance was performed using The Child Behavior Checklist (CBCL)

Results: Age range 6–16 years with a mean age of 10.7±2.9 years, 18 (60%) were males and 12(40%) were females. Seventeen patients (56.6%) were acute leukemia survivors and 10(43.4%) lymphomas and solid tumors. There was statistically significant (p<0.001) decrease in the overall generic PedsQL in cancer survivors (mean 67±11.6) compared to normal children (mean 83.9±12.5) with school functioning area being the most affected (score 47.5±13). ALL survivors had significantly lower mean QOL (62.5±11.8) compared to other cancer survivors (72.8±8.8) (p<0.05). Gender (females) and CNS-directed therapy were risk factors for poorer QOL. Strong agreement between parents and their children QOL rating was seen in most of the QOL domains {overall QOL (p=0.001) physical well being (p=0.04), emotional feelings (p=0.0004), and social interaction (p=0.003) with the strongest correlation in the school domain (p=0.000004)}. Fifty three percent of the survivors showed clinical range of social incompetence with survivors who were diagnosed before the age of 3 were less socially competent than those who were diagnosed after this age (p<0.05), 63% expressed Internalizing behavioral problems and while 23% had Externalizing problems.

CONCLUSION: This results demonstrate Chidhood cancer survivors are at significant risk of poor psychosocial functioning and QOL.

Disclosure: No relevant conflicts of interest to declare.

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