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Objectives The study aimed to explore the attitudes of Swiss healthcare professionals toward the use of social media in adolescent and young adult oncology, and to examine whether the ongoing social restrictions due to COVID-19 might have... more
Objectives The study aimed to explore the attitudes of Swiss healthcare professionals toward the use of social media in adolescent and young adult oncology, and to examine whether the ongoing social restrictions due to COVID-19 might have altered these attitudes. Methods This research was a survey study. The subjects were healthcare providers working in pediatric or adult oncology settings in Switzerland. 62 providers completed the survey. We performed descriptive and inferential statistical analyses. Results While considered useful for various professional aspects (professional life 62.1%, educational purposes 72.7%, networking 83.3%, patient engagement 57.6%, clinical trial recruitment 51.5%), only a small proportion of participants actually used social media for professional reasons weekly (32.8%). Just over half considered themselves skillful in using these platforms (56.1%). Regression analysis revealed that self-assessed skillfulness with social media, the Covid-19 impact on attitudes, and the oncology setting, significantly predicted assessment of the usefulness of social media. Although, in answers to open items, institutional guidelines were deemed crucial to improve social media use, many respondents seemed unaware of their existence (50.8%). Only a minority reported an impact of Covid-19 on their attitudes towards the professional implementation of social media (25.0%). Conclusion The global health crisis creates important challenges for young patients with cancer and their healthcare providers. In times of social restrictions, social media may be a promising tools to facilitate health information provision, connectivity, and patient care. Virtual mentorship and targeted social media training interventions might be a good way to improve familiarity with using social media and to increase awareness about existing ethical guidelines for their use.
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INTRODUCTION: Anecdotal case reports suggest an association between assisted reproduction technologies (ART) and malignant rhabdoid tumors (MRT). We performed a multi-institutional retrospective analysis of the EU-RHAB database,... more
INTRODUCTION: Anecdotal case reports suggest an association between assisted reproduction technologies (ART) and malignant rhabdoid tumors (MRT). We performed a multi-institutional retrospective analysis of the EU-RHAB database, complemented by additional cases outside of EU-RHAB to compile clinical, (epi)genetic characteristics and outcome data of children with MRT following ART. METHODS: Data of 14 patients (from 311 patients with MRT) from 9 countries were analyzed (2010-2018). Tumors and matching blood samples were examined for SMARCB1 mutations using FISH, MLPA and sequencing. Molecular subgroups were determined using DNA methylation arrays and correlated with a validation cohort (n=22, tumor samples of MRT; n=39 blood samples of patients small for gestational age). RESULTS: The median age at diagnosis of the 13 girls and 1 boy was 9 months (0 – 66). 8 patients with ATRT, 3 with extracranial, extrarenal-, 1 with renal rhabdoid tumor and 2 with synchronous tumors were identified...
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PURPOSE Childhood cancer is rare, and treatment is frequently associated with long-term morbidity. Disparities in survival and long-term side-effects encourage the establishment of networks to increase access to complex organ conservative... more
PURPOSE Childhood cancer is rare, and treatment is frequently associated with long-term morbidity. Disparities in survival and long-term side-effects encourage the establishment of networks to increase access to complex organ conservative strategies, such as brachytherapy (BT). We report our experience of an international cooperation model in childhood cancers. METHODS AND MATERIALS We examined the outcome of all children referred to our center from national or international networks to be treated according to a multimodal organ-conservative approach including BT. RESULTS 305 patients were identified; median age at diagnosis was 2.2 years (1.4 months-17.2 years). Ninety-nine (32.4%) were treated within 2015-2020. One hundred seventy-two (56.4%) were referred from national centers and 133 (43.6%) were international patients, from 31 countries (mainly Europe). Two hundred sixty three patients were referred for primary treatment and 42 for salvage treatment. Genito-urinary tumors were the most frequent sites, with 56.4% bladder/prostate rhabdomyosarcoma (RMS) and 28.5% gynecological tumors. In addition to BT, local treatment comprised partial tumor resection in 207 (67.9%) and 39 (13%) had additional external radiotherapy. Median follow-up was 58 months (range: 1 month-48 years), 93 months for national patients and 37 months for international patients (p<.0001). Five-year local control (LC), disease-free survival (DFS) and overall survival rates were 90.8% (CI95%: 87.3-94.4%), 84.4% (CI95%:80.1-89.0) and 93.3% (CI95%:90.1-96.5), respectively. Patients referred for salvage treatment had poorer DFS (p<0.01). Implementation of image-guided pulse-dose rate BT was associated with better LC among RMS patients referred for primary treatment (HR: 9.72; CI95%:1.24-71.0). At last follow-up, 16.7% patients had long-term severe treatment-related complications and two (0.7%) had developed second malignancy. CONCLUSION This retrospective series shows the feasibility of a multinational referral network for brachytherapy allowing high patient number in rare pediatric cancers. High local control probability and acceptable late severe complication probability could be achieved despite very challenging situations. This cooperation model could serve as a basis for generating international reference networks for high-tech radiation such as brachytherapy to increase treatment care opportunities and cure probability.
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Research Interests: Health Communication, Decision Making, Family Medicine, Cancer Epidemiology, Quality of life, and 15 moreFertility, Qualitative Research, Infertility, Adolescent, Medicine, Counseling, Humans, Child, Fertility preservation, Female, Male, Public health systems and services research, Neoplasms, Cross Sectional Studies, and Surveys and Questionnaires
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BACKGROUND Childhood cancer patients are at increased risk of second primary neoplasms (SPNs). We assessed incidence and risk factors for early SPNs with a focus on cancer predisposition syndromes (CPSs). PATIENTS AND METHODS This cohort... more
BACKGROUND Childhood cancer patients are at increased risk of second primary neoplasms (SPNs). We assessed incidence and risk factors for early SPNs with a focus on cancer predisposition syndromes (CPSs). PATIENTS AND METHODS This cohort study used data from the Swiss Childhood Cancer Registry. We included patients with first primary neoplasms (FPNs) diagnosed before age 21 years from 1986 to 2015 and identified SPNs occurring before age 21. We calculated standardised incidence ratios (SIRs) and absolute excess risks (AERs) using Swiss population cancer incidence data, and cumulative incidence of SPNs. We calculated hazard ratios (HRs) of risk factors for SPNs using Fine and Gray competing risk regression. RESULTS Among 8074 childhood cancer patients, 304 (4%) were diagnosed with a CPS and 94 (1%) developed early SPNs. The incidence of SPNs was more than 10-fold higher in childhood cancer patients than the incidence of neoplasms in the general population (SIR = 10.6, 95% confidence interval [CI]: 8.7-13.1) and the AER was 179/100,000 person-years (CI: 139-219). Cumulative incidence of SPNs 20 years after FPN diagnosis was 23% in patients with CPSs (CI: 12-41%) and 2.7% in those without (CI: 2.0-3.6%). Risk factors for SPNs were CPSs (HR = 7.8, CI: 4.8-12.7), chemotherapy (HR = 2.2, CI: 1.1-4.6), radiotherapy (HR = 1.9, CI = 1.2-2.9), haematopoietic stem cell transplantation (HR = 1.8, CI: 1-3.3), and older age (15-20 years) at FPN diagnosis (HR = 1.9, CI: 1.1-3.2). CONCLUSION CPSs are associated with a high risk of SPNs before age 21 years. Identification of CPSs is important for appropriate cancer surveillance and targeted screening.
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Research Interests: Neuropsychology, Pediatrics, Intelligence, Chemotherapy, Adolescent, and 15 moreMedicine, Mental Retardation, Humans, Child, Female, Male, Acute Lymphoblastic Leukaemia, Infant, Central Nervous System, Children and Adolescents, Analysis of Variance, Intelligence tests, Cross Sectional Studies, Neuropsychological Tests, and Child preschool
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ABSTRACTBackgroundVincristine poses a suspected additional risk factor for hearing loss among childhood cancer survivors (CCS) treated with platinum-based chemotherapy, yet evidence is scarce since no study reports vincristine doses. We... more
ABSTRACTBackgroundVincristine poses a suspected additional risk factor for hearing loss among childhood cancer survivors (CCS) treated with platinum-based chemotherapy, yet evidence is scarce since no study reports vincristine doses. We examined the association of vincristine with hearing loss in a national cohort of CCS.MethodsWe included CCS registered in the Swiss Childhood Cancer Registry treated at age ≤ 18 years with platinum-based chemotherapy between 1990–2014. All participants in our retrospective cohort study had audiogram and treatment data from medical records. We identified CCS exposed to vincristine and calculated the total cumulative dose. We defined clinically relevant hearing loss as grade ≥ 2 using the International Society of Pediatric Oncology Boston Ototoxicity Scale at latest follow-up.ResultsOur study population included 270 CCS (43% female; median age at cancer diagnosis 6.8 years; interquartile range [IQR]: 2.1–11.7 years) with median age at audiogram 13.5 y...
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Fever in neutropenia (FN) remains an unavoidable, potentially lethal complication of chemotherapy. Timely administration of empirical broad-spectrum intravenous antibiotics has become standard of care. But the impact of time to... more
Fever in neutropenia (FN) remains an unavoidable, potentially lethal complication of chemotherapy. Timely administration of empirical broad-spectrum intravenous antibiotics has become standard of care. But the impact of time to antibiotics (TTA), the lag period between recognition of fever or arrival at the hospital to start of antibiotics, remains unclear. Here we aimed to analyze the association between TTA and safety relevant events (SRE) in data from a prospective multicenter study. We analyzed the association between time from recognition of fever to start of antibiotics (TTA) and SRE (death, admission to intensive care unit, severe sepsis and bacteremia) with three-level mixed logistic regression. We adjusted for possible triage bias using a propensity score and stratified the analysis by severity of disease at presentation with FN. We analyzed 266 FN episodes, including 53 (20%) with SRE, reported in 140 of 269 patients recruited from April 2016 to August 2018. TTA (median, 1...
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Background. Fever in neutropenia (FN) remains an unavoidable, potentially lethal complication of chemotherapy. Timely administration of empirical broad-spectrum intravenous antibiotics has become standard of care. But the impact of time... more
Background. Fever in neutropenia (FN) remains an unavoidable, potentially lethal complication of chemotherapy. Timely administration of empirical broad-spectrum intravenous antibiotics has become standard of care. But the impact of time to antibiotics (TTA), the lag period between recognition of fever or arrival at the hospital to start of antibiotics, remains unclear. Here we aimed to analyze the association between TTA and safety relevant events (SRE) in data from a prospective multicenter study. Procedure. We analyzed the association between time from recognition of fever to start of antibiotics (F-TTA) and SRE (death, admission to intensive care unit (ICU), severe sepsis and bacteremia) with three-level mixed logistic regression. We adjusted for possible triage bias using a propensity score and stratified the analysis by severity of disease at presentation. Results. We analyzed 266 FN episodes, including 53 (20%) with SRE, reported in 140 of 269 patients recruited from April 201...
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Das Schweizer Kinderkrebsregister feiert dieses Jahr seinen 40. Geburtstag. Es wurde 1976 von der Schweizerischen Padiatrischen Onkologiegruppe als nationales Krebsregister fur Kinder und Jugendliche gegrundet – eine Pionierleistung fur... more
Das Schweizer Kinderkrebsregister feiert dieses Jahr seinen 40. Geburtstag. Es wurde 1976 von der Schweizerischen Padiatrischen Onkologiegruppe als nationales Krebsregister fur Kinder und Jugendliche gegrundet – eine Pionierleistung fur die Schweiz, zu einer Zeit als fur Erwachsene erst vereinzelt regionale Krebsregister entstanden. Heute ist das Schweizer Kinderkrebsregister ein etabliertes epidemiologisches, bevolkerungsbasiertes Register, welches auch detaillierte klinische Daten zu Behandlung, Verlauf und Spatfolgen enthalt. In den 40 Jahren seines Bestehens hat es essentielle bevolkerungsbasierte Daten zur Inzidenz und Prognose, aber auch zu umweltbedingten Risikofaktoren und Spatfolgen von Krebserkrankungen bei Kindern und Jugendlichen aus der Schweiz erhoben und ausgewertet, und ist damit ein unverzichtbares Instrument geworden fur Monitoring und Forschung zu Krebserkrankungen bei jungen Menschen.
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Childhood cancer survivors treated with hematopoietic stem cell transplantation are at high risk for pulmonary morbidity and mortality. In this retrospective study we described transplant characteristics of pediatric patients who... more
Childhood cancer survivors treated with hematopoietic stem cell transplantation are at high risk for pulmonary morbidity and mortality. In this retrospective study we described transplant characteristics of pediatric patients who underwent hematopoietic stem cell transplantation in Switzerland and how these characteristics changed over time, compared self-reported pulmonary outcomes between transplanted and non-transplanted survivors, and investigated risk factors for the reported pulmonary outcomes. As part of the population-based Swiss Childhood Cancer Survivor Study, we sent questionnaires to all ≥5-year childhood cancer survivors diagnosed 1976–2010 at age ≤20 years. We included 132 transplanted survivors and 368 matched non-transplanted survivors. During the study period transplant characteristics changed, with decreasing use of total body irradiation and increased use of peripheral blood stem cells and mismatched and unrelated donors as transplant source. One-fifth of transpla...
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Background: Physical activity (PA) can reduce the risk of chronic adverse health conditions in childhood cancer survivors. We examined physical activity and sedentary screen time behavior in a nationwide study in Switzerland. Procedures:... more
Background: Physical activity (PA) can reduce the risk of chronic adverse health conditions in childhood cancer survivors. We examined physical activity and sedentary screen time behavior in a nationwide study in Switzerland. Procedures: The Swiss Childhood Cancer Survivor Study sent questionnaires to parents of all Swiss resident ≥5 year-survivors diagnosed 1995-2010. We assessed physical activity including compulsory school sport, recreational sport, commuting to school, and time spent with screen media in those aged 5-15 years, and compared results to international recommendations. Results: We included 766 survivors with a median age at diagnosis of 2.8 (interquartile range 1.4-5.0) years and a median age at study of 12.5 (10.0-14.3) years. Median PA time was 7.3 (4.8-10.0) hours/week and median screen time 1.4 (0.8-2.0) hours/day. Compulsory school sport hours and walking or cycling to school contributed significantly to total PA. 55% of survivors met PA and 68% screen time reco...
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Follow-up care is important for childhood cancer survivors to facilitate early detection and treatment of late effects. We aimed to describe preferences for different organisational aspects and models of follow-up care among Swiss... more
Follow-up care is important for childhood cancer survivors to facilitate early detection and treatment of late effects. We aimed to describe preferences for different organisational aspects and models of follow-up care among Swiss childhood cancer survivors, and characteristics associated with preferences for different models. We contacted 720 survivors aged 18+ years, diagnosed with cancer after 1990 (age 0-16 years), registered in the Swiss Childhood Cancer Registry (SCCR), and Swiss resident, who previously participated in a baseline survey. They received questionnaires to assess attendance and preferences for follow-up (rated on 4-point scales, 0-3). Clinical information was available from the SCCR. Survivors (n = 314: response rate 43.6%; 47.8% still attended follow-up) rated clinical reasons for follow-up higher than supportive reasons (p < .001). They rated checking for cancer recurrence (mean = 2.78, SD = 0.53) and knowing about risks for my children most important (mean ...
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Of 54 children with acute lymphoblastic leukemia (ALL) and first hematological recurrence observed between 1985 and 1989, 31 relapsed while still on treatment and 23 after cessation of therapy. Of the former, only one survived. Of the... more
Of 54 children with acute lymphoblastic leukemia (ALL) and first hematological recurrence observed between 1985 and 1989, 31 relapsed while still on treatment and 23 after cessation of therapy. Of the former, only one survived. Of the latter, 11 children survived after a minimum follow‐up of 25 months. During the same period, a first isolated testicular relapse was observed in nine boys, of whom six survived, and an isolated CNS relapse in eight patients, of whom three survived. As a rule, survivors of a bone marrow or testicular relapse were doing well while those surviving a CNS relapse had considerable neuropsychological sequelae. These results, compared with those of two preceding studies, suggest that with intensification of front‐line treatments, it becomes more difficult to rescue children who relapse, particularily those with a bone marrow relapse while on therapy. © 1994 Wiley‐Liss, Inc.