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Clinical evaluation of late outcomes in Dutch childhood cancer survivors: Methodology of the DCCSS LATER 2 study
Authors:Elizabeth A. M. Feijen  Jop C. Teepen  Eline van Dulmen-den Broeder  Marry M. van den Heuvel-Eibrink  Margriet van der Heiden-van der Loo  Helena J. H. van der Pal  Andrica C. H. de Vries  Marloes Louwerens  Dorine Bresters  Birgitta Versluys  Hanneke de Ridder  Margreet Veening  Flora E. van Leeuwen  Martha Grootenhuis  Heleen Maurice-Stam  Hanneke M. van Santen  Sebastian J. C. M. M. Neggers  Saskia Pluijm  Jaap den Hartogh  Cécile M. Ronckers  Wim J. E. Tissing  Jacqueline J. Loonen  Leontien C. M. Kremer
Affiliation:1. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands;2. Department of Pediatric Oncology/Hematology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands;3. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

Department of Pediatric Oncology/Hematology, Erasmus Medical Center, Rotterdam, The Netherlands;4. Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands;5. Department of Epidemiology and Biostatistics, Netherlands Cancer Institute, Amsterdam, The Netherlands;6. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

Department of Pediatric Endocrinology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, The Netherlands;7. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

Department of Medicine, Endocrinology Section, Pituitary Center Rotterdam, Erasmus University Medical Center, Rotterdam, The Netherlands;8. Department VOX Survivors, Dutch Childhood Cancer Parent Organization VOKK Netherlands, Nieuwegein, The Netherlands;9. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

Brandenburg Medical School, Institute of Biostatistics and Registry Research, Neuruppin, Germany;10. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

Department of Pediatric Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;11. Radboudumc Center of Expertise for Cancer Survivorship, Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands

Abstract:

Background

Childhood cancer survivors face late health problems; despite advances in research, details on risk remain unclear. We describe the methodological aspects of the Dutch Childhood Cancer Survivor Study (DCCSS) cross-sectional clinical study (LATER 2 study).

Procedure

From the multi-center DCCSS LATER cohort of 6165 five-year survivors diagnosed during 1963–2001, we invited 4735 eligible survivors in 2016, as well as siblings and parents of survivors. Gaps in evidence identified during development of surveillance guidelines were translated into clinical research questions for 16 outcome-specific subprojects. The regular care visit to the LATER outpatient clinic forms the backbone of outcome assessment complemented with research-defined measurements (physical examination, clinical tests, questionnaires). Furthermore, blood/saliva samples were taken for deoxyribonucleic acid (DNA) extraction.

Results

In total, 2519 (53.2%) survivors participated in the LATER 2 study. When comparing participants with nonparticipants, we observed that males, CNS survivors, and those treated with surgery only were less likely to participate. Of the participating survivors, 49.3% were female. Median time since childhood cancer diagnosis was 26.9 years (range 14.8–54.7 years) and median attained age was 34.4 years (range 15.4–66.6 years).

Conclusions

The high-quality data generated in the LATER 2 study will provide valuable insights into risks of and risk factors for clinical and physical and psychosocial health outcomes and factors for early recognition of those health outcomes in long-term childhood cancer survivors. This will contribute to fill in important gaps in knowledge and improve the quality of life and care for childhood cancer survivors.
Keywords:childhood cancer survivors  clinical study  late outcomes  methodology  questionnaires
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