Cancer
Symptom burden and health-related quality of life in pediatric cancer after treatment completion Krishtee Napit* Krishtee Napit Don Coulter Daisy Dai Katrina Cordts Evi Farazi Shinobu Watanabe-Galloway
Background
With advanced treatments, survivors are living longer. However, they often experience symptom burden after treatment completion, which deteriorates their health-related quality of life (HRQoL). The association between HRQoL and symptom burden in pediatric cancer after treatment completion remains understudied.
Methods
We conducted a cross-sectional study of 136 pediatric cancer survivors aged 10-25 who completed treatment within 8 years from 2 major hospitals in Nebraska. We used a survey to collect data during their hospital visit, the validated Memorial Symptom Assessment Scale tool to collect information on the presence, frequency, severity, and distress of 30 symptoms, and the PedsQoL instrument to measure the HRQoL. At least for one symptom, the distress level should be ‘1-4’ to be considered for symptom burden. The burden was categorized as higher and lower if the total symptoms were 13-30 and 1-12, respectively. We conducted a multiple linear regression model to find the association between HRQoL and symptom burden at a significance level with a p-value of less than 0.05 and an adjusted beta coefficient.
Results
The mean age, year since diagnosis and treatment completion were 14.91, 4.66, and 3.05, respectively, and the mean symptoms number was 6.06. Around 79% experienced symptom burden. Difficulty concentrating (48.53%), lack of energy (45.59%), and feeling drowsy (45.59%) were the most common symptoms. The mean HRQoL score was 80.84 out of 100. The presence of a higher symptom burden negatively influenced HRQoL in bivariate analysis. The adjusted model, which included co-variates based on literature, showed that higher symptom burden (β= -4.66, p-value=0.0004) and education of father high school vs less than high school (β= -4.46, p-value=0.0147) were associated with HRQoL.
Conclusion
Even after the treatment completion, symptom burden is prevalent in pediatric cancer survivors, and the prevalence of a higher symptom burden degrades the HRQoL.