Patient-reported health status during pediatric cancer treatment.

BACKGROUND: Changes in patient function and factors affecting pediatric patients with cancer during treatment are largely unknown. The purpose of this study was to measure patient-reported outcomes (PROs) in children during the initial 6 months of therapy to characterize function and explore factors associated with function including type of cancer, intensity of therapy, age, and gender.

PROCEDURE: We conducted a prospective cohort study of children aged 5-21 newly diagnosed with cancer. PROs were obtained twice monthly over the first 6 months of treatment. The Patient-Reported Outcome Measurement Information System (PROMIS) was used to measure patient mobility, fatigue, pain interference, peer relationships, anxiety, and depressive symptoms. A generalized linear mixed model was used to analyze changes by domain over time.

RESULTS: Forty patients completed the study with a mean age of 11.7 years (standard deviation [SD] 4.7), 60% had leukemia/lymphoma. All patients report improved pain over time (P = 0.008). Patients with central nervous system (CNS)/solid tumor report better mobility (P < 0.001), less fatigue (P < 0.001), less pain (P < 0.001), less anxiety (P < 0.001), fewer depressive symptoms (P < 0.001), and better peer relationships (P = 0.0036). Younger patients report worse mobility (P = 0.017), more fatigue (P = 0.032), more pain (P < 0.001), more anxiety (P = 0.017), and more depressive symptoms (P = 0.005).

CONCLUSIONS: Pain improved for all patients over the first 6 months of cancer treatment. Age and tumor type also affected patient-reported function for all domains. Understanding the burden of cancer treatment is critical to refine supportive care interventions to minimize the burden of pediatric cancer treatment.