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      The association between vincristine‐induced peripheral neuropathy and health‐related quality of life in children with cancer

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          Abstract

          Purpose

          Vincristine (VCR) is a chemotherapeutic agent used in the treatment of pediatric oncology patients, but its main toxicity is VCR‐induced peripheral neuropathy (VIPN). However, whether VIPN has an effect on health‐related quality of life (HR‐QoL) in children during treatment is unknown. Therefore, the aim of our study was to investigate the association between VIPN and HR‐QoL in children starting treatment for cancer.

          Methods

          Measurements of VIPN were performed using two tools: Common Terminology Criteria for Adverse Events (CTCAE) and pediatric‐modified Total Neuropathy Score (ped‐mTNS). Assessment of HR‐QoL was done with self‐ and proxy assessment of the Cancer and Generic module of the Pediatric Cancer Quality of Life Inventory™ (PedsQL).

          Results

          In total, N = 86 children were included. HR‐QoL of children with VIPN ( n = 67%, 76%) was significantly lower in comparison with children without VIPN: estimated Total score of PedsQL Generic (proxy) 84.57; β = −8.96 and 95% confidence interval (CI) −14.48 to −3.43; p = 0.002, estimated PedsQL Generic Total score (self‐reported): 85.16, β = −8.38 (95% CI: −13.76 to −3.00); p = 0.003. Similar results were found in the Pain and Hurt domain of the PedsQL Cancer (pain: estimated score [proxy]: 85.28, β = −9.94 [95%CI: −16.44 to −3.45], p = 0.003; hurt: estimated score [self‐report] 97.57, β = −19.15 [95%CI: −26.82 to −11.48], p < 0.001).

          Conclusion

          VIPN results in a significant reduction of HR‐QoL in children under treatment for a malignancy, which means that VIPN is important for the well‐being of pediatric oncology patients. Therefore, this study underlines the importance of optimizing treatment with VCR, thereby aiming to reduce VIPN while maintaining efficacy.

          Abstract

          This article reports on the association between vincristine‐induced peripheral neuropathy and health‐related quality of life in pediatric oncology patients. Our data show that health‐related quality of life is significantly lower in children who experience vincristine‐induced peripheral neuropathy compared to pediatric oncology patients without vincristine‐induced peripheral neuropathy.

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          Most cited references32

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          PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations.

          The PedsQL (Pediatric Quality of Life Inventory) (Children's Hospital and Health Center, San Diego, California) is a modular instrument for measuring health-related quality of life (HRQOL) in children and adolescents ages 2 to 18. The PedsQL 4.0 Generic Core Scales are multidimensional child self-report and parent proxy-report scales developed as the generic core measure to be integrated with the PedsQL Disease-Specific Modules. The PedsQL 4.0 Generic Core Scales consist of 23 items applicable for healthy school and community populations, as well as pediatric populations with acute and chronic health conditions. The 4 PedsQL 4.0 Generic Core Scales (Physical, Emotional, Social, School) were administered to 963 children and 1,629 parents (1,677 subjects accrued overall) recruited from pediatric health care settings. Item-level and scale-level measurement properties were computed. Internal consistency reliability for the Total Scale Score (alpha = 0.88 child, 0.90 parent report), Physical Health Summary Score (alpha = 0.80 child, 0.88 parent), and Psychosocial Health Summary Score (alpha = 0.83 child, 0.86 parent) were acceptable for group comparisons. Validity was demonstrated using the known-groups method, correlations with indicators of morbidity and illness burden, and factor analysis. The PedsQL distinguished between healthy children and pediatric patients with acute or chronic health conditions, was related to indicators of morbidity and illness burden, and displayed a factor-derived solution largely consistent with the a priori conceptually-derived scales. The results demonstrate the reliability and validity of the PedsQL 4.0 Generic Core Scales. The PedsQL 4.0 Generic Core Scales may be applicable in clinical trials, research, clinical practice, school health settings, and community populations.
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            Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes.

            Our model proposes a taxonomy or classification scheme for different measures of health outcome. We divide these outcomes into five levels: biological and physiological factors, symptoms, functioning, general health perceptions, and overall quality of life. In addition to classifying these outcome measures, we propose specific causal relationships between them that link traditional clinical variables to measures of HRQL. As one moves from left to right in the model, one moves outward from the cell to the individual to the interaction of the individual as a member of society. The concepts at each level are increasingly integrated and increasingly difficult to define and measure. AT each level, there are an increasing number of inputs that cannot be controlled by clinicians or the health care system as it is traditionally defined.
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              Childhood and adolescent cancer statistics, 2014.

              In this article, the American Cancer Society provides estimates of the number of new cancer cases and deaths for children and adolescents in the United States and summarizes the most recent and comprehensive data on cancer incidence, mortality, and survival from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries (which are reported in detail for the first time here and include high-quality data from 45 states and the District of Columbia, covering 90% of the US population). In 2014, an estimated 15,780 new cases of cancer will be diagnosed and 1960 deaths from cancer will occur among children and adolescents aged birth to 19 years. The annual incidence rate of cancer in children and adolescents is 186.6 per 1 million children aged birth to 19 years. Approximately 1 in 285 children will be diagnosed with cancer before age 20 years, and approximately 1 in 530 young adults between the ages of 20 and 39 years is a childhood cancer survivor. It is therefore likely that most pediatric and primary care practices will be involved in the diagnosis, treatment, and follow-up of young patients and survivors. In addition to cancer statistics, this article will provide an overview of risk factors, symptoms, treatment, and long-term and late effects for common pediatric cancers. © 2014 American Cancer Society, Inc.
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                Author and article information

                Contributors
                mi.vandevelde@amsterdamumc.nl
                Journal
                Cancer Med
                Cancer Med
                10.1002/(ISSN)2045-7634
                CAM4
                Cancer Medicine
                John Wiley and Sons Inc. (Hoboken )
                2045-7634
                01 November 2021
                November 2021
                : 10
                : 22 ( doiID: 10.1002/cam4.v10.22 )
                : 8172-8181
                Affiliations
                [ 1 ] Emma Children’s Hospital Amsterdam UMC Vrije Universiteit Amsterdam Pediatric oncology Amsterdam The Netherlands
                [ 2 ] Princess Máxima Center for Pediatric Oncology Utrecht The Netherlands
                [ 3 ] Emma Children’s Hospital Amsterdam UMC Amsterdam Medical Center Pediatric Oncology Amsterdam The Netherlands
                [ 4 ] Department of Epidemiology and Biostatistics Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands
                [ 5 ] Department of Pediatric Hemato‐Oncology UZ Leuven Leuven Belgium
                [ 6 ] Department of Pediatrics Clinique MontLégia CHC Liège Belgium
                [ 7 ] Department of Pediatric Onco‐Hematology Universitair Ziekenhuis Brussel Brussels Belgium
                [ 8 ] Department of Paediatric Haematology‐Oncology and Stem Cell Transplantation Ghent University Hospital Ghent Belgium
                Author notes
                [*] [* ] Correspondence:

                Mirjam E. van de Velde, Department of Pediatric Oncology/Hematology, Amsterdam UMC, ZH 8D12, Postbus 7057, 1007 MB Amsterdam, The Netherlands.

                Email: mi.vandevelde@ 123456amsterdamumc.nl

                Author information
                https://orcid.org/0000-0003-0424-2085
                Article
                CAM44289
                10.1002/cam4.4289
                8607258
                34725942
                beb6e13f-f2e0-45be-a1f9-c574c211be39
                © 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 July 2021
                : 14 May 2021
                : 17 August 2021
                Page count
                Figures: 3, Tables: 3, Pages: 10, Words: 7008
                Funding
                Funded by: Belgian Health Care Knowledge Centre
                Award ID: 16015
                Funded by: Netherlands Organization for Health and Development
                Award ID: 836021006
                Categories
                Research Article
                Cancer Prevention
                Research Articles
                Custom metadata
                2.0
                November 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.9 mode:remove_FC converted:22.11.2021

                Oncology & Radiotherapy
                cancer,children,neurotoxicity,pedsql
                Oncology & Radiotherapy
                cancer, children, neurotoxicity, pedsql

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