Health Outcomes for Hodgkin Disease Survivors

霍奇金病幸存者的健康结果

• 批准号: 6763537
• 负责人: Debra L Friedman
• 金额: $ 45.58万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-21 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6763537
• 关键词: Hodgkin' s disease; clinical research; depression; human morbidity; human subject; long term survivor; longitudinal human study; myocardium disorder; neoplasm /cancer chemotherapy; neoplasm /cancer radiation therapy; outcomes research; patient oriented research; posttraumatic stress disorder; pulmonary fibrosis /granuloma; quality of life; questionnaires; sign /symptom; social psychology; therapy adverse effect; thyroid disorder

DESCRIPTION (provided by applicant): Survival from pediatric Hodgkin disease now exceeds 85%, resulting in a growing cohort of survivors who are at risk for adverse long-term health-related outcomes. With changes in multi-modality therapy over time, the incidence and spectrum of such outcomes is likely to change. Despite data on long-term adverse health-related outcomes for patients treated in the 1960's through the early 1980's, little information has been systematically collected regarding similar outcomes for patients treated in the more contemporary era from 1987 to the present. This latter period was notable for therapeutic studies designed, in part, to reduce long-term morbidity and mortality. Such therapeutic changes included a reduction the use of alkylating agents, authracyclines, and radiotherapy doses and fields, specifically to decrease adverse long-term outcomes in areas of cardiopulmonary, endocrine, reproductive and psychological health and to decrease the incidence of secondary malignant neoplasms. The cumulative incidence and spectrum of these adverse long-term outcomes for Hodgkin disease survivors is not known. As a result, survivors and health care providers are unclear about the need for long-term surveillance for late morbidity, or the manner in which it should be delivered. The proposed research will utilize two unique resources in a collaborative manner: the Childhood Cancer Survivor Study (CCSS), an NCI-supported 27-institution cohort study tracking the outcomes of 14.000 childhood cancer (1905 Hodgkin disease) survivors and the Children's Oncology Group, the NCI-supported 238-institution pediatric cooperative group, which is responsible for developing therapeutic and late effects studies for the majority of pediatric patients in North America. From these unique resources, we have identified 13 institutions, with clinical and research infrastructures to support risk-based outcomes studies. In these institutions we have identified 1051 Hodgkin disease survivors, treated after 1986 on or in parallel to risk-adapted cooperative group protocols. In this cohort of survivors, using a combination of self-report and clinical evaluation, we will: l) determine the cumulative incidence and characterize the spectrum of selected adverse physiologic and psychosocial outcomes; 2) compare the cumulative incidence and spectrum of self-reported adverse outcomes with a cohort of patients treated from 1975 to 1986, with data collected at a comparable time period since diagnosis; and 3) compare and validate self-reported health-related outcomes with those detected by clinical evaluations or medical record review.

描述（由申请人提供）： 小儿霍奇金疾病的生存率现在超过85％，导致越来越多的幸存者有危害与长期健康相关的不良后果的风险。随着多模式治疗的变化，随着时间的流逝，这种结果的发生率和频谱可能会改变。尽管在1960年代至1980年代初期接受治疗的患者的长期不良健康相关结局数据，但系统地收集了有关从1987年到现在的更现代时代治疗的患者的类似结果的信息。后一个时期是针对旨在降低长期发病率和死亡率的治疗研究而闻名的。这种治疗性的变化包括减少烷基化剂，身份验证剂和放射疗法剂量和田间的使用，特别是为了减少心肺，内分泌，生殖和心理健康和降低次要恶性肿瘤的发生率的不良长期结局。霍奇金疾病幸存者的这些不良长期结局的累积发生率和频谱尚不清楚。结果，幸存者和医疗保健提供者尚不清楚需要长期监视以延迟发病率或应交付方式。 The proposed research will utilize two unique resources in a collaborative manner: the Childhood Cancer Survivor Study (CCSS), an NCI-supported 27-institution cohort study tracking the outcomes of 14.000 childhood cancer (1905 Hodgkin disease) survivors and the Children's Oncology Group, the NCI-supported 238-institution pediatric cooperative group, which is responsible for developing therapeutic and北美大多数儿科患者的后期研究。从这些独特的资源中，我们通过临床和研究基础设施确定了13个机构，以支持基于风险的结果研究。在这些机构中，我们已经确定了1051个霍奇金疾病幸存者，并在1986年以后或与适应风险的合作团体方案并行处理。在这种幸存者中，使用自我报告和临床评估的结合，我们将：l）确定累积发生率并表征所选不良生理和社会心理结局的光谱； 2）将自我报告的不良后果的累积发生率和累积发生率与1975年至1986年接受治疗的患者的累积发生率和比较，以及自诊断以来在可比的时间内收集的数据； 3）比较和验证与自我报告的与健康相关的结果与临床评估或医疗记录审查所检测到的结果。