Two groundbreaking studies published in JAMA and JAMA Pediatrics highlight the significant impact of routine symptom screening on symptom management in paediatric oncology. These studies provide the first Level 1 evidence in children regarding the benefits of remote symptom monitoring using electronic patient-reported outcomes (ePROs). The trials, led by prominent members of the SIOP community, promise to transform paediatric cancer care by improving symptom detection and management, ultimately enhancing patient outcomes.

The research investigated whether symptom screening with feedback and management care pathways could reduce symptom burden in paediatric cancer patients. Results demonstrated that symptom screening significantly improved patient-reported outcomes, as measured by the Symptom Screening in Pediatrics Tool (SSPedi).

In the first study, a large cluster-randomized trial conducted across 20 paediatric cancer centres in the U.S., 445 patients aged 8-18 years newly diagnosed with cancer were randomized to either receive thrice-weekly symptom screening or usual care. The findings revealed that the symptom screening group reported a significantly lower 8-week SSPedi score (7.9 vs. 11.4), indicating reduced symptom burden. A reduction was evident across all symptoms.
Similarly, the second study, a randomized clinical trial conducted across 8 Canadian paediatric cancer centres, also found that daily symptom screening for hospitalized patients resulted in better symptom control, with significant improvements observed by day 5.

These studies support the growing body of evidence suggesting that ePROs can significantly enhance symptom management in paediatric oncology. By enabling timely identification of troubling symptoms, healthcare providers can intervene earlier and tailor treatment strategies to alleviate patient discomfort, thus improving overall quality of life for young cancer patients.

The research team is now focusing on translating these findings into actionable tools that can be widely adopted in clinical practice. Efforts are underway to develop implementation guides and integrate ePRO software into routine cancer care. This will ensure that the benefits of symptom screening are accessible to all paediatric oncology centres, helping alleviate the often-overlooked burden of cancer-related symptoms in children.

The success of these trials is a testament to the leadership and dedication of SIOP members who are at the forefront of paediatric oncology research. Lillian Sung, Lee Dupuis, Christina Baggott, David R. Freyer, Wade Kyono, Andrea D. Orsey, Adam J. Esbenshade, Donna L. Johnston, David Dix, Ketan Kulkarni, Serina Patel, Magimairajan lssai Vanan, and Paul Gibson’s contributions to this pioneering work are set to redefine how healthcare teams manage symptoms in paediatric cancer patients, ultimately ensuring that children receive the best possible care.

To learn more about these transformative studies, read the full articles published in JAMA and JAMA Pediatrics:

• Symptom Screening Linked to Care Pathways for Pediatric Patients With Cancer: A Randomized Clinical Trial | Cancer Screening, Prevention, Control | JAMA
• Symptom Screening for Hospitalized Pediatric Patients With Cancer: A Randomized Clinical Trial | Cancer Screening, Prevention, Control | JAMA

These studies represent a significant leap forward in paediatric cancer care, demonstrating that systematic symptom screening and timely intervention can significantly reduce the burden of cancer symptoms. As we continue to gather evidence and improve implementation strategies, the future of paediatric oncology looks brighter, with patients benefiting from more personalized and responsive care.