Survivorship guidelines in pediatric and adolescent radiation oncology: a systematic review

Abstract

Purpose As survival rates for childhood and young adult cancer continue to improve, there is a growing need for comprehensive survivorship care that addresses long-term health outcomes after radiation treatment. This review aimed to synthesize and critically appraise national and international survivorship guidelines.Methods Literature searches were performed across MEDLINE, Embase, and CINAHL, quality appraisal was completed using the AGREE II checklist and JBI critical appraisal tools. Screening and data extraction were completed in Covidence by two independent reviewers. Studies were included if they identified as survivorship guidelines, models of care, or pathways relevant to young cancer survivors. Exclusion criteria comprised non-cancer populations and studies unrelated to survivorship.Results The literature search resulted in 626 articles, with 14 records included in the final analysis. All included records were deemed high quality. Publications provided limited guidance on structured organ-at-risk survivorship management. Cardiotoxicity, neurocognitive impairment, endocrine dysfunction, and secondary malignancies were commonly identified as treatment-related toxicities.Conclusion Evidence-based survivorship guidelines were exclusively international, with no Australian equivalents identified. Despite global consensus on core survivorship principles, major gaps remain in monitoring radiation-exposed organs in Australian relevant resources.