Sara Cho1, Courtney Tromburg2, Caitlin Forbes1,3, Andrew Tran4, Elleine Allapitan4, Taryn Fay-McClymont5, Kathleen Reynolds3,6, Fiona Schulte7,8. 1. Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C3, Canada. 2. Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada. 3. Alberta Children's Hospital, Haematology, Oncology, and Transplant Program, Calgary, AB, Canada. 4. Department of Psychology, University of Calgary, Calgary, AB, Canada. 5. Department of Paediatrics, University of Calgary, Calgary, AB, Canada. 6. Department of Family Medicine, University of Calgary, Calgary, AB, Canada. 7. Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C3, Canada. Fiona.schulte@ahs.ca. 8. Alberta Children's Hospital, Haematology, Oncology, and Transplant Program, Calgary, AB, Canada. Fiona.schulte@ahs.ca.
Abstract
PURPOSE: The objectives of this review were to (1) summarize studies that described social adjustment in survivors of pediatric ALL across the lifespan, (2) summarize social adjustment outcomes reported across studies, and (3) examine associations between social adjustment and disease/treatment- and non-treatment-related factors. METHODS: Searched databases included EMBASE (Ovid), MEDLINE (Ovid), PsycINFO (EBSCO Information Services), and Web of Science (Thomson Reuters). Eligible studies included: (1) original research; (2) published in English; (3) a diagnosis of cancer between 0 and 21 years; (4) survivors at least 5 years from diagnosis and/or 2 years from therapy completion; and (5) quantitative assessment of social adjustment. RESULTS: The literature search yielded 3698 articles of which 43 were included in the final review. Risk of bias was assessed using domains adapted from the Cochrane risk-of-bias tool. Quality of evidence was evaluated following the Grading of Recommendations Assessment Development and Evaluation (GRADE) criteria. There was some evidence that school-aged and adolescent/young adult survivors experienced worse social adjustment compared to controls. There was some evidence suggesting cranial radiation therapy (CRT) is associated with social adjustment difficulties among young adult survivors. Inconsistent evidence was found for relapse, age at diagnosis and study, sex, and late effects in relation to social adjustment. CONCLUSION: Survivors of pediatric ALL were at higher risk of social adjustment difficulties compared to controls. However, evidence for treatment and non-treatment risk and resilience factors require stronger evidence. IMPLICATIONS FOR CANCER SURVIVORS: Information on modifiable factors that modulate social adjustment may influence targets of intervention and follow-up guidelines.
PURPOSE: The objectives of this review were to (1) summarize studies that described social adjustment in survivors of pediatric ALL across the lifespan, (2) summarize social adjustment outcomes reported across studies, and (3) examine associations between social adjustment and disease/treatment- and non-treatment-related factors. METHODS: Searched databases included EMBASE (Ovid), MEDLINE (Ovid), PsycINFO (EBSCO Information Services), and Web of Science (Thomson Reuters). Eligible studies included: (1) original research; (2) published in English; (3) a diagnosis of cancer between 0 and 21 years; (4) survivors at least 5 years from diagnosis and/or 2 years from therapy completion; and (5) quantitative assessment of social adjustment. RESULTS: The literature search yielded 3698 articles of which 43 were included in the final review. Risk of bias was assessed using domains adapted from the Cochrane risk-of-bias tool. Quality of evidence was evaluated following the Grading of Recommendations Assessment Development and Evaluation (GRADE) criteria. There was some evidence that school-aged and adolescent/young adult survivors experienced worse social adjustment compared to controls. There was some evidence suggesting cranial radiation therapy (CRT) is associated with social adjustment difficulties among young adult survivors. Inconsistent evidence was found for relapse, age at diagnosis and study, sex, and late effects in relation to social adjustment. CONCLUSION: Survivors of pediatric ALL were at higher risk of social adjustment difficulties compared to controls. However, evidence for treatment and non-treatment risk and resilience factors require stronger evidence. IMPLICATIONS FOR CANCER SURVIVORS: Information on modifiable factors that modulate social adjustment may influence targets of intervention and follow-up guidelines.
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