Quality of Life and Management of Pediatric Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Pediatric Oncology".

Deadline for manuscript submissions: 30 April 2025 | Viewed by 4340

Special Issue Editors


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Guest Editor
Polistudium SRL, Milan, Italy
Interests: palliative care; research methodology; consensus approaches; cancer; pediatrics
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Guest Editor
Center Maria Letizia Verga, University of Milano-Bicocca, 20900 Monza, Italy
Interests: hematological diseases; hematooncological diseases; psychosocial issues; communication
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Worldwide, more than 4 million children suffer from oncological disease. In this setting, pediatric palliative care (PPC) must not be limited to the terminality period, but it should be rather established as early as possible and continue over the disease trajectory, regardless of treatment administration, with the aim to improve the quality of life of patients and their families (see Benini et al, Cancers 2022).

The Special Issue ‘Quality of life and Management of Pediatric Cancer’ aims at collecting, in a single editorial effort, experiences and well-grounded opinions on the management of pediatric cancers from all over the world. In particular, studies concerning the early establishment of PPC in the oncology setting would be welcome.

Our audience is multidisciplinary and composed of oncologists, palliative care specialists, nurses and psychologists with an interest in PPC.

You may choose our Joint Special Issue in Current Oncology.

Dr. Luca Giacomelli
Dr. Momcilo Jankovic
Guest Editors

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Keywords

  • pediatric palliative care
  • oncology
  • quality of life
  • early management

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Related Special Issue

Published Papers (3 papers)

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Research

17 pages, 433 KiB  
Article
Characterization of Patient Activation among Childhood Cancer Survivors in the St. Jude Lifetime Cohort Study (SJLIFE)
by Megan E. Ware, Angelica De La Cruz, Qian Dong, Kyla Shelton, Tara M. Brinkman, I-Chan Huang, Rachel Webster, Brian Potter, Kevin Krull, Sedigheh Mirzaei, Matthew Ehrhardt, Melissa M. Hudson, Gregory Armstrong and Kirsten Ness
Cancers 2024, 16(18), 3220; https://doi.org/10.3390/cancers16183220 - 21 Sep 2024
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Abstract
Background: Patient activation describes a willingness to take action to manage health and is associated with health outcomes. The purpose of this study was to characterize patient activation and its association with psychological outcomes and health behaviors in childhood cancer survivors. Methods: Participants [...] Read more.
Background: Patient activation describes a willingness to take action to manage health and is associated with health outcomes. The purpose of this study was to characterize patient activation and its association with psychological outcomes and health behaviors in childhood cancer survivors. Methods: Participants were from the St. Jude Lifetime Cohort Study (SJLIFE). Activation levels (1–4, 4 = highest activation) were measured with the Patient Activation Measure (PAM). Psychological outcomes and health behaviors were obtained via self-report. Cognitive function was assessed by trained examiners. ANOVA or chi-squared tests were utilized to assess group-level differences in activation. Multivariable regression models were used to assess associations between PAM scores and outcomes of interest. Results: Among 2708 survivors and 303 controls, more survivors endorsed lower activation levels than the controls (11.3 vs. 4.7% in level 1) and fewer survivors endorsed the highest level of activation than the controls (45.3 vs. 61.5% in level 4). Not endorsing depression (OR: 2.37, 95% CI 1.87–2.99), anxiety (OR: 2.21, 95% CI 1.73–2.83), and somatization symptoms (OR: 1.99, 95% CI 1.59–2.50), general fear (OR: 1.45, 95% CI 1.23–1.71) and body-focused (OR: 2.21, 95% CI 1.83–2.66), cancer-related worry, and physical (OR: 2.57, 95% CI 2.06–3.20) and mental (OR: 2.08, 95% CI 1.72–2.52) HRQOL was associated with higher levels of activation. Lower activation was associated with not meeting physical activity guidelines (OR: 2.07, 95% CI 1.53–2.80). Conclusions: Survivors endorsed lower activation levels than peers. Interventions to improve physical and psychological health outcomes could leverage these results to identify survivors who benefit from support in patient activation. Full article
(This article belongs to the Special Issue Quality of Life and Management of Pediatric Cancer)
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8 pages, 1080 KiB  
Communication
Beyond Needles: Pioneering Pediatric Care with Virtual Reality (VR) for TIVAD Access in Oncology
by Rubén Caballero, Albert Pasten, Carla Giménez, Raquel Rodríguez, Rosa María Carmona, Jaume Mora, Arnau Valls-Esteve, Pamela Lustig, Federica Lombardini, Sol Balsells and Lucas Krauel
Cancers 2024, 16(12), 2187; https://doi.org/10.3390/cancers16122187 - 11 Jun 2024
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Abstract
Introduction: Pediatric oncology patients use totally implantable venous access devices (TIVADs) to enable central venous access. Anxiety, pain and/or discomfort are common despite anesthesia. Virtual reality (VR) is a non-pharmacological approach that may reduce pain and anxiety in these patients. We aimed to [...] Read more.
Introduction: Pediatric oncology patients use totally implantable venous access devices (TIVADs) to enable central venous access. Anxiety, pain and/or discomfort are common despite anesthesia. Virtual reality (VR) is a non-pharmacological approach that may reduce pain and anxiety in these patients. We aimed to assess the use of VR for reducing anxiety/pain in patients with TIVADs while facilitating the task of healthcare providers when accessing a TIVAD. Methods: patients 4–18 years old with a TIVAD were prospectively randomized to an intervention group (IG) or a control group (CG). In the IG, VR goggles (Oculus Quest 2, Meta Platforms®, Menlo Park, CA, USA) were used displaying a relaxing video in the Raja Ampat environment (Ecosphere app from Phoria®) while the TIVAD was accessed. The CG was managed as per standard of care. Satisfaction and pain were measured by FPS-R and STAIC scales, respectively. Results: this is the report of a prospective, randomized (60 per group)—unblinded—, single institution study of 120 pediatric oncology patients enrolled from January to April 2022. Median ages for IG and CG were 9.22 and 10.52 years, respectively. Satisfaction was higher in the IG (4.80) compared to the CG (3.92), p ≤ 0.0001. Regarding pain, mean FPS-R scores were 1.79 for the CG and 0.83 for the IG. Significantly different scores were found in the 12 to 18 years group, p ≤ 0.05. The healthcare professionals index of satisfaction was high (4.50 mean Likert score) for the IG compared to accessing the TIVAD without VR (3.73 mean Likert score). Conclusion: The use of VR helped reduce pain and/or discomfort in pediatric oncology patients, mainly in the older age group as they can better interact with VR. Healthcare providers were satisfied with the help of VR for TIVAD management. Full article
(This article belongs to the Special Issue Quality of Life and Management of Pediatric Cancer)
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12 pages, 232 KiB  
Article
Outcome of Tocilizumab Treatment in Febrile Neutropenic Children with Severe Sepsis/Septic Shock in a Single-Center Retrospective Case Series
by Shih-Hsiang Chen, Tsung-Yen Chang, Yi-Lun Wang, En-Pei Lee, Jainn-Jim Lin, Yi-Wen Hsiao, Tang-Her Jaing, Chao-Ping Yang and Iou-Jih Hung
Cancers 2024, 16(8), 1512; https://doi.org/10.3390/cancers16081512 - 16 Apr 2024
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Abstract
Purpose: To assess the efficacy of an IL-6 blockade with tocilizumab on treatment outcome of severe sepsis/septic shock in children with febrile neutropenia. Methods: We performed a retrospective study of febrile neutropenic patients younger than 18 years old who developed severe sepsis/septic shock [...] Read more.
Purpose: To assess the efficacy of an IL-6 blockade with tocilizumab on treatment outcome of severe sepsis/septic shock in children with febrile neutropenia. Methods: We performed a retrospective study of febrile neutropenic patients younger than 18 years old who developed severe sepsis/septic shock at a single medical center between November 2022 and October 2023. Results: Seven patients with febrile neutropenia complicated with severe sepsis/septic shock were identified. Four of seven patients received tocilizumab in addition to standard of care. The median IL-6 level before administration of tocilizumab was 14,147 pg/mL (range: 672–30,509 pg/mL). All four patients successfully recovered from severe sepsis/septic shock. Three of seven patients received standard of care without tocilizumab. IL-6 levels were checked intwo2 patients, with a median of 1514.5 (range: 838–2191). Only one of three (33%) patients without tocilizumab therapy made a full recovery from severe sepsis/septic shock. The mortality rate was higher in patients without tocilizumab therapy compared to patients with tocilizumab therapy (67% vs. 0%). Conclusions: Administration of tocilizumab reduced mortality of severe sepsis/septic shock in children with febrile neutropenia. However, it warrants confirmation with a larger number of patients and a longer follow-up. Full article
(This article belongs to the Special Issue Quality of Life and Management of Pediatric Cancer)

Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Home Management of End of Life Oncologic Pediatric Patients: A Short Review and Italian Local Experience
Authors: Alessandra Brugiolo
Affiliation: Ospedale San Bortolo ULSS 8 Berica Vicenza
Abstract: Abstract: Background. The main goal of pediatric palliative care (PPC) is to improve or maintain the best possible quality of life (QoL) for the child and their family. PPC can be provided in community health centers, within the specialist health care service and/or in the child’s home. Home is often the preferred place for families, and recommendations state that, whenever possible, the family home should be the center of care for the child. Cancer patients constitute an important group in pediatric palliative care. Pediatric palliative oncology (PPO) is an emerging field that integrates the principles of palliative care early into the illness trajectory of children with cancer. PPO providers work with interdisciplinary clinicians to provide optimal medical and psychosocial care to children with cancer and their families. Methods In this short review we’ll illustrate our experience of home management of terminal pediatric oncologic patients. Conclusions: this brief report supports the need to expand the offer of home care to all pediatric cancer patients in the terminal phase due to the positive effects on the general well-being of patients and their families

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