Quality of Life as a Predictor of Childhood Cancer Treatment Abandonment

Abstract

Background: Childhood cancer comes with a huge burden of medical and economic consequences on the child and family. The toxicities associated with treatment cause increased morbidity, and impact on their quality of life. This study set out to compare the quality of life of children adhering to cancer treatment versus children who abandon treatment using the Lansky Play Performance Scale score indices. Methodology: The study was a prospective, hospital-based survey in two tertiary paediatric oncology centres in north-western Nigeria conducted between February–August 2022. Consecutive patients registered for cancer treatment were enrolled, and data depicting demography, pathologic diagnosis and treatment outcome was collated. Cases without a confirmed histologic/cytologic diagnosis of cancer were excluded. The Lansky Play Performance Scale (LPPS) was used to assess the quality of life, and categorized as fully active, normal (score 100, Group I); mild restriction (score 70-90, Group II); moderate restriction (score 50-60, Group III); severe restriction (20-40, Group IV) and disabled (score 0-10, Group V). Results: There were 51 patients in the study, aged 1-16 years (mean 7.2+3.8), male: female ratio 1.4:1. There were 12(23.5%) leukaemia, 11(21.6%) retinoblastoma, 10(19.6%) lymphoma, 9(17.6%) rhabdomyosarcoma, 6(11.8%) nephroblastoma, 2(3.9%) neuroblastoma and 1(2.0%) carcinoma cases. Treatment-related adverse events occurred in 20(39.2%) patients. The LPPS scores were: Group I - 15(29.4%), Group II - 18(35.3%), Group III - 4(7.8%), Group IV - 13(25.5%), Group V - 1(2.0%). There were 33(64.7%) patients on follow-up, 10(19.6%) mortalities and 8(15.7%) cases of abandonment. In the abandonment category, 4(50%) were LPPS Group I, 3(37.5%) Group II and 1(12.5%) Group III. In addition, 6(75%) had no change in LPPS, while 1(12.5%) each had a positive change and negative change respectively. The risk of abandonment was not statistically significant based on LPPS.Conclusion: The study found that treatment abandonment was commoner among patients with normal or mild impairment of play activity.