Objectives/Purpose
As survival rates for childhood and adolescent young adult (AYA) cancer continue to improve, there is a growing need for comprehensive survivorship care that addresses long-term health outcomes. The purpose of this systematic review was to synthesise national and international guidelines and policies, with a focus on health-related quality of life, monitoring the function of organs at risk following radiation treatment, and managing treatment-related late effects in cancer survivors.
Sample and Setting
A systematic review of national and international survivorship guidelines published since 2015 in paediatric and adolescent radiation oncology.
Procedures
After protocol registration (Record ID 526498) literature searches were performed in Medline, Embase, and CINAHL using relevant key terms. We also searched grey literature. Inclusion criteria were publication after 2015, paediatric or AYA cohorts and radiation management. Data screening and extraction were performed using Covidence by three reviewers with critical appraisal via the AGREE II checklist.
Results
The search identified 589 articles; with 14 meeting inclusion criteria.Guidelines originated from the USA (n=4), Europe (n=2) and Australia (n=8). Many guidelines covered multiple tumour cohorts, yet few provided specific detail relevant to paediatric and AYA populations. Survivorship approaches included risk-based, patient-centred care plans, late effects monitoring, and psychosocial care. While quality of life and long-term outcomes were addressed, there was minimal guidance on structured follow-up for organs at risk post-radiation therapy.
Conclusion and Clinical Implications
There is international agreement on key elements of survivorship care, but this review highlighted gaps in the routine follow-up of radiation-exposed organs. A national consensus on post-radiation surveillance protocols is urgently needed to standardise care, reduce late morbidity, and guide clinical decision-making. Embedding organ-specific follow-up into survivorship care plans, supported by multidisciplinary teams and digital tools such as PROMs, will be critical to improving long-term outcomes for childhood and adolescent and young adult cancer survivors.