Understanding Pain and Quality of Life in Paediatric Cancer Survivors: A Systematic Review with a Focus on Early Survivorship
Abstract
Highlights
- Children and young people (CYP) who survive cancer—particularly females—are more likely than the general population to report acute and chronic pain in later life, and they frequently experience comorbidities such as fatigue, depression, and anxiety. Yet, their pain is often likely to be under-recognized, especially in childhood, partly due to a lack of developmentally sensitive assessment tools in CYP.
- This study demonstrates that the poor understanding of post-cancer treatment pain in children and young people (CYP) stems not only from the absence of adapted assessment tools but also from limited early post-treatment data. Together, these shortcomings create a significant gap in mapping CYP pain trajectories after cancer.
- Our findings highlight the urgent need for timely, rigorous, age-specific research to better inform survivorship care and shape evidence-based clinical policy. Our study also suggests that clinicians should routinely assess both acute and chronic pain in CYP cancer survivors using validated, age-appropriate tools in early post-treatment completion assessments.
Abstract
1. Introduction
2. Materials and Methods
2.1. Databases Searched
2.2. Endpoints
2.3. Inclusion Criteria
2.4. Risk of Bias
3. Results
3.1. Data Extraction
3.2. Quality Assessment
3.3. Data Synthesis
3.3.1. Characteristics of Included Studies
3.3.2. Methods for Measuring Pain
3.4. Pain Prevalence
3.4.1. Chronic Pain
3.4.2. Acute Pain
3.4.3. Treatment-Related Pain
3.5. Pain Correlates
3.5.1. Biological
3.5.2. Psychological
3.5.3. Quality of Life
4. Discussion
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Element | Inclusion Criteria | Exclusion Criteria |
---|---|---|
Population (P) | Children diagnosed with cancer between the ages of 0 and 21 years; survivors aged 2–24 years who were at least 5 years post-diagnosis and/or 2 years post-completion of therapy. | Children diagnosed after the age of 21; survivors older than 24 years. |
Intervention (I) | All cancer-related treatments. | Studies not within 5 years post-diagnosis and/or 2 years post-completion of therapy. |
Comparator (C) | Studies with and without a comparison group. | None. |
Outcomes (O) | Acute and chronic pain, quality of life, and psychological outcomes. | Studies in which pain was not assessed at all. |
Study design (S) | Randomized controlled trials and cohort studies. | Reviews, editorials, conference abstracts, dissertations, books, book chapters, letters, and case studies. |
Study | Confounding | Participant Selection | Intervention Classification | Missing Data | Outcome Measurement |
---|---|---|---|---|---|
Arpaci T. [25] | X | + | - | - | X |
Berg C. [26] | - | + | X | - | + |
Bowers DC. [27] | X | + | X | + | + |
Brinkman TM. [28] | X | X | X | - | + |
Crom DB. [29] | - | X | X | - | + |
Feeny D. [30] | X | - | - | - | + |
Hsiao CC. [31] | X | X | X | - | + |
Khan BR. [32] | - | + | X | - | + |
Kranick SM. [33] | X | + | - | - | X |
Schultz KAP. [34] | - | + | X | - | X |
Lieber S. [35] | - | + | X | - | - |
Odame I. [36] | - | + | X | - | + |
Portwine C. [37] | - | + | X | - | + |
Van Dijk EM. [38] | X | X | X | - | X |
Revel-Vilk S. [39] | X | X | X | - | X |
Sadighi Z. [40] | X | + | X | - | + |
Schwartz LA. [41] | X | + | X | - | + |
Williamson LR. [42] | X | X | X | - | X |
Health-related quality of life or health status measures | 14 (77.77%) |
Valid pain measures | 1 (5.5%) |
Chart review | 1 (5.5%) |
Author-created measures | 5 (27.7%) |
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Di Domenico, F.; Liossi, C.; Géranton, S.M. Understanding Pain and Quality of Life in Paediatric Cancer Survivors: A Systematic Review with a Focus on Early Survivorship. Children 2025, 12, 1320. https://doi.org/10.3390/children12101320
Di Domenico F, Liossi C, Géranton SM. Understanding Pain and Quality of Life in Paediatric Cancer Survivors: A Systematic Review with a Focus on Early Survivorship. Children. 2025; 12(10):1320. https://doi.org/10.3390/children12101320
Chicago/Turabian StyleDi Domenico, Francesca, Christina Liossi, and Sandrine Martine Géranton. 2025. "Understanding Pain and Quality of Life in Paediatric Cancer Survivors: A Systematic Review with a Focus on Early Survivorship" Children 12, no. 10: 1320. https://doi.org/10.3390/children12101320
APA StyleDi Domenico, F., Liossi, C., & Géranton, S. M. (2025). Understanding Pain and Quality of Life in Paediatric Cancer Survivors: A Systematic Review with a Focus on Early Survivorship. Children, 12(10), 1320. https://doi.org/10.3390/children12101320