Supportive interventions for childhood cancer: An umbrella review of randomized evidence

Georgios Lavasidis; Georgios Markozannes; Kirsten Voorhies; Nikolaos A Trikalinos; Eleni Th Petridou; Orestis A Panagiotou; Evangelia E Ntzani

doi:10.1016/j.critrevonc.2022.103845

Supportive interventions for childhood cancer: An umbrella review of randomized evidence

Crit Rev Oncol Hematol. 2022 Dec:180:103845. doi: 10.1016/j.critrevonc.2022.103845. Epub 2022 Oct 17.

Authors

Georgios Lavasidis¹, Georgios Markozannes², Kirsten Voorhies³, Nikolaos A Trikalinos⁴, Eleni Th Petridou⁵, Orestis A Panagiotou⁶, Evangelia E Ntzani⁷

Affiliations

¹ Evidence-based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, 45110 Ioannina, Greece; Department of Ophthalmology, Marienhospital Osnabrück, Bischofsstraße 1, 49074 Osnabrück, Germany; Department of Ophthalmology, Elpis General Hospital of Athens, Dimitsanas 7, 11522 Athens, Greece. Electronic address: lavasidis@outlook.com.gr.
² Evidence-based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, 45110 Ioannina, Greece; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, London W2 1PG, United Kingdom. Electronic address: georgemarkozannes@gmail.com.
³ Department of Biostatistics, Brown University School of Public Health, 121 South Main St., Providence, RI 02912, USA; Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, 401 Park Drive, Suite 401 East, Boston, MA 02215, USA. Electronic address: kirsten_voorhies@alumni.brown.edu.
⁴ Division of Medical Oncology, Department of Internal Medicine, Washington University School of Medicine, 1 Barnes Jewish Hospital, St Louis, MO 63110, USA. Electronic address: ntrikalinos@wustl.edu.
⁵ Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece. Electronic address: epetrid@med.uoa.gr.
⁶ Department of Health Services, Policy & Practice, Brown University School of Public Health, 121 South Main St., Providence, RI 02912, USA; Center for Evidence Synthesis in Health, Brown University School of Public Health, 121 South Main St., Providence, RI 02912, USA; Department of Epidemiology, Brown University School of Public Health, 121 South Main St., Providence, RI 02912, USA. Electronic address: orestis_panagiotou@brown.edu.
⁷ Evidence-based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, 45110 Ioannina, Greece; Department of Health Services, Policy & Practice, Brown University School of Public Health, 121 South Main St., Providence, RI 02912, USA; Center for Evidence Synthesis in Health, Brown University School of Public Health, 121 South Main St., Providence, RI 02912, USA. Electronic address: entzani@uoi.gr.

PMID: 36261115
DOI: 10.1016/j.critrevonc.2022.103845

Abstract

Therapeutic advancements have improved pediatric cancer prognosis, shifting the interest towards the management of psychosocial burden and treatment-related morbidity. To critically appraise the available evidence, we conducted an umbrella review of meta-analyses of randomized controlled trials on supportive interventions for childhood cancer. Thirty-four publications (92 meta-analyses, 1 network, 14,521 participants) were included. The most concrete data showed a reduction in procedure-related pain and distress through hypnosis. Moreover, exercise improved the functional mobility of the patients. Regarding pharmacological interventions, most of the meta-analyses pertained to the treatment of nausea/vomiting (ondansetron was effective) and infections/febrile neutropenia [granulocyte-(macrophage) colony-stimulating factors showed benefits]. Substantial heterogeneity was detected in 31 associations. Conclusively, supportive interventions for pediatric cancer are being thoroughly evaluated. However, most of the studies are small and of moderate quality, highlighting the need for more randomized evidence in order to increase precision in improving the quality of life of patients, survivors and their families.

Keywords: Adverse events; Chemotherapy; Childhood cancer; Randomized controlled trials; Supportive interventions; Umbrella review.

Publication types

Review

MeSH terms

Child
Humans
Nausea
Neoplasms* / drug therapy
Quality of Life
Randomized Controlled Trials as Topic
Survivors
Vomiting