中低收入国家儿童癌症幸存者治疗后期的身体影响:系统综述。

IF 3.1 2区 医学 Q2 ONCOLOGY
Journal of Cancer Survivorship Pub Date : 2025-06-01 Epub Date: 2024-01-06 DOI:10.1007/s11764-023-01517-8
Kevin A Wong, Alexandra Moskalewicz, Paul C Nathan, Sumit Gupta, Avram Denburg
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引用次数: 0

摘要

目的:在高收入国家的儿童癌症幸存者中,治疗带来的身体晚期效应已得到充分证实,但中低收入国家(LMIC)的患病率和风险因素是否具有可比性尚不清楚。我们进行了一项系统性综述,以评估中低收入国家儿童癌症幸存者的身体晚期反应结果:方法:检索了五个健康科学数据库,检索时间从开始到 2022 年 11 月,使用所有语言。我们纳入了在低收入和中等收入国家进行的观察性研究,这些研究评估了治疗对儿童癌症幸存者身体的后期影响。队列随访的平均值或中位数必须距最初的癌症诊断时间≥5年:结果:共纳入 16 篇完整文章和 5 篇会议摘要。研究在中低收入国家(12 篇,占 57%)或中高收入国家(9 篇,占 43%)进行;近一半的研究(9 篇,占 43%)在印度进行。5个队列(24%)完全由5年存活者组成。据报道,0-11% 的幸存者(n = 10 项研究)随后发生了恶性肿瘤。甲状腺功能减退症和代谢综合征的发病率分别为 2-49%(4 项研究)和 4-17%(5 项研究)。性腺功能障碍的发生率为 3-47%(4 项研究)。心脏功能障碍为 1-16%(3 项研究)。对肌肉骨骼和泌尿系统的晚期影响调查最少:结论:在低收入国家儿童癌症幸存者方面存在巨大的知识差距。没有发现低收入国家的数据。在中等收入国家,对晚期影响的定义和评估不尽相同,并受到选择偏差和样本量小的限制:对低收入和中等收入国家癌症幸存者的启示:低收入和中等收入国家的幸存者可能会经历治疗后的身体晚期效应,但还需要从幸存者队列中系统收集数据,以填补知识空白。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Physical late effects of treatment among survivors of childhood cancer in low- and middle-income countries: a systematic review.

Purpose: Physical late effects of treatment are well-documented among childhood cancer survivors in high-income countries, but whether prevalence and risk factors are comparable in low- and middle-income countries (LMICs) is unclear. We conducted a systematic review to assess physical late effect outcomes among childhood cancer survivors in LMICs.

Methods: Five health sciences databases were searched from inception to November 2022 in all languages. We included observational studies conducted in LMICs that evaluated physical late effects of treatment in childhood cancer survivors. Mean or median cohort follow-up must have been ≥ 5 years from original cancer diagnosis.

Results: Sixteen full articles and five conference abstracts were included. Studies were conducted in lower-middle (n = 12, 57%) or upper-middle income (n = 9, 43%) countries; nearly half (n = 9, 43%) were conducted in India. Five cohorts (24%) were comprised entirely of 5-year survivors. Subsequent malignant neoplasms were reported in 0-11% of survivors (n = 10 studies). Hypothyroidism and metabolic syndrome prevalence ranged from 2-49% (n = 4 studies) and 4-17% (n = 5 studies), respectively. Gonadal dysfunction ranged from 3-47% (n = 4 studies). Cardiac dysfunction ranged from 1-16% (n = 3 studies). Late effects of the musculoskeletal and urinary systems were least investigated.

Conclusions: Substantial knowledge gaps exist in LMIC childhood cancer survivorship. No low-income country data were found. In middle-income countries, late effects were defined and assessed variably and limited by selection bias and small sample sizes.

Implications for cancer survivors: Survivors in LMICs can experience physical late effects of treatment, though additionally systematically collected data from survivor cohorts are needed to fill knowledge gaps.

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来源期刊
CiteScore
7.00
自引率
10.80%
发文量
149
审稿时长
>12 weeks
期刊介绍: Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.
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