Dynamische monitoring en risicobepaling van vermoeidheid in overlevers van kinderkanker

As survival rates among children and adolescents treated for cancer have increased substantially, the long-term consequences of childhood cancer treatment have become increasingly important determinants of their daily quality of life. One of the most frequently reported and burdensome symptoms is fatigue, with prevalence rates reaching up to 85% among childhood cancer survivors. Although fatigue has a major negative impact on daily functioning, there is currently no standard of care to monitor or alleviate it. This is largely due to limited knowledge about specific risk groups, the timing and duration of fatigue symptoms, and their associations with physical and psychological factors. Because fatigue is a fluctuating symptom, it is essential to identify its dynamic risk factors in detail. Therefore, this project aimed to identify patient- and time-related risk factors contributing to the development of fatigue. We continuously monitored the dynamics of psychological experiences (e.g., fatigue, anxiety, depression) as well as physiological, environmental, and stress-related parameters (e.g., heart rate variability, physical activity, sleep patterns) using innovative real-life assessment methods in 100 childhood cancer survivors. These included ecological momentary assessments through app-based questionnaires and objective monitoring of physical activity and sleep patterns using multisensor wearables. This approach enabled us to capture the dynamic associations between fatigue, stress, worry, insomnia, reduced physical activity, and biological alterations. Understanding these interrelations is crucial for identifying targets for personalized interventions to reduce fatigue and, ultimately, enhance the daily quality of life of children and adolescents after cancer treatment.