Determinants of Quality of Life in Pediatric Cancer Survivors: A Systematic Review to Inform Follow-Up Protocols

Purpose. To identify factors that significantly impact quality of life (QoL) in pediatric cancer survivors and determine their relevance over time, aiming to inform evidence-based follow-up protocols. Methods. A systematic review (PROSPERO CRD42024589922) was conducted using PubMed, Scopus, CINAHL, and Web of Science (May 21, 2023). Search terms covered family and caregiving, pediatric cancer, QoL, and determinants. Studies were included if they assessed pediatric cancer survivors using validated QoL questionnaires. Two reviewers screened titles and abstracts, and data were extracted independently. Results. Sixty-two studies were included, employing 4 cancer-specific and 11 generic QoL instruments. Twenty-eight determinants were identified across five domains: cancer, treatment, child, family & caregiver, and community. Child- and treatment-related factors were most frequently significant, with physical functioning, age, and gender consistently affecting outcomes. Family and socioeconomic variables were particularly relevant in early survivorship (< 5 years post-treatment). Community-level factors, such as social support, were underrepresented. Conclusion. QoL in pediatric cancer survivors is influenced by multifactorial determinants spanning medical, psychosocial, and environmental domains. By integrating these findings into follow-up protocols, healthcare providers can offer personalized support to at-risk survivors. Tailored, stage-specific interventions targeting clinical and psychosocial needs could enhance long-term outcomes.