Associated risk factors of quality of life in children receiving cancer treatment over the past decade: A systematic review and meta-analysis.
This systematic review and meta-analysis of 21 studies involving 1,884 pediatric patients found that radiotherapy and/or chemotherapy, higher cancer risk, poor physical functioning, and parental divorce or separation were associated with poorer quality of life.
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This systematic review and meta-analysis of 21 studies involving 1,884 pediatric patients found that radiotherapy and/or chemotherapy, higher cancer risk, poor physical functioning, and parental divorce or separation were associated with poorer quality of life.
Research significance
The evidence identifies clinical, functional, and family-level correlates of impaired quality of life; it supports the inference that toxicity management, physical-function support, psychological care, nutrition, and family support could be tested as risk-targeted adjunctive interventions, but the review does not establish that these approaches improve outcomes.
Source abstract
PURPOSE: Although quality of life (QoL) in children with cancer is now a clinical priority, risk-factor evidence remains fragmented. This review aims to identify risk factors associated with impaired QoL in pediatric cancer patients. METHODS: Fifteen databases were searched for studies published between March 2015 and March 2025. Study selection, data extraction, and quality assessment were independently conducted by two reviewers. RevMan 5.4 and Stata 15 were employed for meta-analyses. RESULTS: A total of 21 studies were included, encompassing 1884 participants ranging in age from 0 to 19 years. Four major risk factors affecting QoL in children with cancer were identified: receiving radiotherapy and/or chemotherapy (SMD = 0.90, p < 0.00001), having a higher cancer risk (SMD = 0.71, p = 0.002), poor physical functioning (SMD = 0.79, p < 0.00001), and parental divorce/separation (SMD = 0.92, p = 0.0001). CONCLUSION: Receiving radiotherapy and/or chemotherapy, having a higher cancer risk, poor physical functioning, and parental divorce/separation were associated with poorer QoL in pediatric cancer patients. The research over the past decade has shown progressive diversification of tumor types, increasing adoption of longitudinal designs, globalization of study sites, and multidimensional influences on QoL. IMPLICATIONS TO PRACTICE: Future research should examine the effects of novel adjunctive therapies on the QoL of children with cancer using standardized tools and longitudinal designs. Risk-targeted interventions guided by the socio-ecological model should be developed to improve QoL, including management of treatment-related toxicities, psychological distress, physical activity, nutrition, and family support.