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. 2023 Sep-Oct;73(5):524-545.
doi: 10.3322/caac.21783. Epub 2023 May 9.

Clinical practice guideline and expert consensus recommendations for rehabilitation among children with cancer: A systematic review

Allison J L'Hotta  1 , Samantha B Randolph  2 , Ben Reader  3 , Kim Lipsey  4 , Allison A King  5   6
Affiliations

Clinical practice guideline and expert consensus recommendations for rehabilitation among children with cancer: A systematic review

Allison J L'Hotta et al. CA Cancer J Clin. 2023 Sep-Oct.

Abstract

Increased attention to the rehabilitation needs of children with cancer is vital to enhance health, quality-of-life, and productivity outcomes. Among adults with cancer, rehabilitation recommendations are frequently incorporated into guidelines, but the extent to which recommendations exist for children is unknown. Reports included in this systematic review are guideline or expert consensus reports containing recommendations related to rehabilitation referral, evaluation, and/or intervention for individuals diagnosed with cancer during childhood (younger than 18 years). Eligible reports were published in English from January 2000 to August 2022. Through database searches, 42,982 records were identified; 62 records were identified through citation and website searching. Twenty-eight reports were included in the review: 18 guidelines and 10 expert consensus reports. Rehabilitation recommendations were identified in disease-specific (e.g., acute lymphoblastic leukemia), impairment-specific (e.g., fatigue, neurocognition, pain), adolescent and young adult, and long-term follow-up reports. Example recommendations included physical activity and energy-conservation techniques to address fatigue, referral to physical therapy for chronic pain management, ongoing psychosocial surveillance, and referral to speech-language pathology for those with hearing loss. High-level evidence supported rehabilitation recommendations for long-term follow-up care, fatigue, and psychosocial/mental health screening. Few intervention recommendations were included in guideline and consensus reports. In this developing field, it is critical to include pediatric oncology rehabilitation providers in guideline and consensus development initiatives. This review enhances the availability and clarity of rehabilitation-relevant guidelines that can help prevent and mitigate cancer-related disability among children by supporting access to rehabilitation services.

Keywords: cancer; cancers of childhood; child; consensus; physical medicine; practice guideline; rehabilitation; survivorship.

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Conflict of interest statement

Conflict of Interest: Dr. Allison King discloses a consulting payment from Global Blood Therapeutics unrelated to the current work. No additional disclosures or conflicts of interest.

Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses Diagram
Figure 2.
Figure 2.
Number of Guidelines and Expert Consensus Reports in which each Discipline is Mentioned in the Context of Referral, Evaluation, or Intervention
See this image and copyright information in PMC

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