Cardiorespiratory fitness in childhood cancer survivors: a systematic review and meta-analysis
Bibliographic record
Abstract
AIMS: Cardiovascular disease (CVD) is a leading cause of mortality in childhood cancer survivors (CCS) that may be related to the cardiotoxic effects of radiation or chemotherapy and concomitant reductions in cardiorespiratory fitness. Therefore, we sought to compare cardiorespiratory fitness (peak oxygen uptake, V̇O2peak) between CCS and age-matched non-cancer controls (CON). Secondary outcomes included haemodynamics and resting cardiac function. METHODS AND RESULTS: Embase, Scopus, MEDLINE, CINAHL, and SPORTDiscus databases were searched from inception to June 2023 for eligible studies. Cross-sectional studies with V̇O2peak measured in CCS and CON were included. Differences in outcomes and pooled estimates for each outcome were estimated from a fixed-effects meta-analysis and between-group differences were reported as a weighted mean difference (WMD). Of 2026 studies identified, 18 reported V̇O2peak (CCS: n = 786, 44% female, mean age: 16 years, time post-therapy: 5.8 years; CON: n = 1379, 50% female, mean age: 16 years). V̇O2peak was lower in CCS [WMD: -7.08 mL/kg/min, 95% confidence interval (CI): -7.75 to -6.42, I2: 79%, n = 2165] with no difference for peak exercise heart rate (WMD: -1.4 b.p.m., 95% CI: -3.0 to 0.2, I2: 63%, n = 741). Resting left ventricular ejection fraction (WMD: -1.61%, 95% CI: -2.60 to -0.62, I2: 49%, n = 222) and systolic blood pressure were lower (WMD: -3.8 mmHg, 95% CI: -5.7 to -1.9, I2: 25%, n = 184) while resting heart rate was higher in CCS (WMD: 4.9 bpm; 95% CI: 1.8-7.9, I2: 55%, n = 262). CONCLUSION: Childhood cancer survivors have a marked reduction in cardiorespiratory fitness (7.1 mL/kg/min lower than CON) that may have important prognostic implications for their future risk of CVD and mortality.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.023 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.034 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".