Health-related quality of life in Chinese children and adolescents with cancer: A systematic review and meta-analysis.

Childhood and adolescent cancer in China is on the rise, and the long-term adverse effects of treatment have increasingly compromised the health-related quality of life (HRQoL) of affected patients. This review aimed to elucidate HRQoL among Chinese children and adolescents with cancer and to critically summarize the multifactorial determinants influencing their well-being. A comprehensive search was conducted across both Chinese and English databases for studies published from 2010 to December 2024. The review initially identified a broad set of literature, which was subsequently refined through rigorous inclusion and exclusion criteria to yield a final sample of 36 studies encompassing 4968 patients. Findings indicate that HRQoL is generally poor in this population, with particularly notable deficits in school functioning. In total, 28 influential factors were identified and categorized into four main groups: clinical factors, demographic characteristics, child health and behavioral status, and family and social conditions. Common determinants included disease severity, the complexity of treatment regimens, frequent post-treatment adverse effects, the physical and psychological states of both patients and their parents, as well as family economic conditions, family structure, and the extent of social support. Although these findings provide valuable insights, the absence of standardized guidelines and intervention protocols calls for further research with larger sample sizes and extended follow-up periods. Ultimately, the review underscores the need for targeted policy and support measures to systematically improve the HRQoL of Chinese children and adolescents with cancer.