Cardiopulmonary Fitness and Its Clinical Determinants of a Population of Childhood Cancer Survivor
Condition: Childhood Cancer
Study type: Observational

Summary: 
      Medical progress have made it possible to considerably improve the survival of children with
      an oncological disease. Currently, the survival rate increased to above 90 % in the most
      developed countries . This increase of childhood cancer survivors (CCS) asks us about their
      future and their quality of life. Assessing health related life quality , previous studies
      observe that in this particular population of patients, it is related to a poor physical
      capacity , physical activity level and many of these patients do not meet the activity level
      recommended by the world health organization due to fatigability and sedentary behaviours .
      In addition to these habits, the CCS are more susceptible to develop cardiovascular risk
      (CVR) leading to cardiovascular disease in adulthood and increases them mortality .
      Furthermore, CCS who have been experiencing hematopoietic stem cells transplantation (HSCT)
      are more susceptible to develop these CVR. In parallel with the common CVR, lower
      cardiopulmonary fitness assessed by cardiopulmonary exercise test (CPET) in the general
      population has been established as a major and independent CVR for cardiologic events.

      Cardiopulmonary fitness assessed by maximal cardiopulmonary exercise test (CPET) allows
      physicians to measure metabolic response to maximal effort in a population that is known as
      VO2max. This domain of applied physiology permits a new way to approach the understanding of
      global health prognosis in chronic disease. For example, decrease of VO2max is involved in
      lower quality of life in patients with congenital heart disease. Cardiopulmonary exercise
      test for VO2max exploration has been demonstrated feasible in child patients with leukemia or
      other tumors after intensive chemotherapy, prior to HSCT.

      Assessment of cardiopulmonary fitness in CCS is already described in previous studies, but
      this study aimed to compare a maximal CPET assessment on a large childhood cancer survivors
      cohort with healthy control, on a quite young cohort, during the oncologic follow up and find
      out its determinants.
    

Detailed description: 
      This is a controlled, monocentric, cross-sectional study conducted in a tertiary care center
      for oncologic disease in children (Montpellier University Hospital, France) was carried out
      between November 2010 and November 2020.

      Two groups were identified: CCS group and control group.
    

Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        -  CCS having been complete a full regimen for oncological disease and considered in
             remission at the end of treatment

          -  Controlled children with completely normal check-up, including physical examination,
             ECG, echocardiography and spirometry
      
Keywords: childhood cancer survivors; VO2max; Ventilatory anaerobis threshold; Cardio-pulmonary exercise test; Hematopoietic stem cells transplantation; Radiotherapy