title: Pediatric quality of life in long-term survivors of childhood cancer treated with anthracyclines.
abstract: Anthracyclines are a common class of drugs used to treat pediatric cancer. While much attention is given to their cardiotoxicity, little is known about the relationship between the use of anthracyclines and health-related quality-of-life (HRQoL) outcomes. This study examines the association of anthracycline cardiotoxicity risk status and Pediatric Quality-of-Life (PedsQL) InventoryTMscores in childhood cancer METHODS: Pediatric cancer survivors aged 8-21 who were at least 5 years posttreatment were recruited from a Cancer Survivor Clinic. Participants completed the PedsQL 4.0 Generic Core Scales and a health behavior survey. Linear regression was used to evaluate the association between PedsQL scores and anthracycline cardiotoxicity risk status and to assess whether self-reported physical activity modified the association.
  
  
  
  Eighty survivors participated and were characterized by cardiotoxicity risk status (high: 12; moderate: 23, low: 24, no risk: 21) as defined by the Children's Oncology Group (COG). Measures in all PedsQL domains tended to be slightly lower for survivors exposed to anthracyclines as compared to the unexposed. The largest difference in unadjusted mean scores was for social functioning (96.0% for unexposed vs. 91.3% for exposed, P = 0.0068). There was also an inverse dose-response relation between adjusted PedsQL scores and increasing anthracycline cardiotoxicity risk; this association was not modified by physical activity level.
  
  
  
  These data indicate that regular psychosocial assessments, such as those currently recommended by the COG, may be especially important for survivors treated with anthracyclines.
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia. ARyerson@cdc.gov.
authors.forename: A Blythe
authors.initials: AB
authors.lastname: Ryerson
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.|Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Karen
authors.initials: K
authors.lastname: Wasilewski-Masker
authors.affiliation: Sibley Heart Center Cardiology, Atlanta, Georgia.|Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: William L
authors.initials: WL
authors.lastname: Border
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Michael
authors.initials: M
authors.lastname: Goodman
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.|Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Lillian
authors.initials: L
authors.lastname: Meacham
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Harland
authors.initials: H
authors.lastname: Austin
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.|Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Jordan Gilleland
authors.initials: JG
authors.lastname: Marchak
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.|Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.|Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Ann C
authors.initials: AC
authors.lastname: Mertens
mesh_terms: D000293:Adolescent; D018943:Anthracyclines / Q000009:adverse effects*; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D066126:Cardiotoxicity; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000523:psychology; D011788:Quality of Life; D017741:Survivors; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic
keywords: anthracyclines; oncology; pediatric cancer survivors; quality of life