review · Cancer Survivorship Research & Care
Childhood and young adult cancer survival rates are rising, prompting a need for structured survivorship care addressing long-term health outcomes following radiation therapy. A systematic review examined global literature across major medical databases, appraising guidelines using standard quality checklists. Out of 626 records screened, 14 high-quality publications met the criteria. Commonly identified long-term radiation complications included heart toxicity, cognitive impairment, hormonal dysfunction, and secondary cancers. However, existing publications provide limited structured guidance for managing organs at risk after radiation exposure. Furthermore, all reviewed evidence-based guidelines originated internationally, with an absence of Australian-specific equivalents. While global consensus exists around general survivorship principles, substantial gaps remain in guidance for monitoring organs exposed to radiation within Australian healthcare contexts.
As more children and adolescents survive cancer, radiation-related health issues can emerge years after treatment. Understanding gaps in current clinical guidance helps healthcare systems identify where clearer protocols are needed, particularly for monitoring high-risk organs, to protect long-term health and ensure consistent follow-up care for young cancer survivors.
The findings can inform the development of standardised clinical protocols, digital follow-up pathways, and risk-monitoring software for oncology care teams and healthcare organisations. Because the work is a systematic review identifying guideline gaps rather than a tested product, practical applications remain at an early design stage, requiring the formulation and validation of dedicated organ-monitoring guidelines before integration into clinical care.
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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.
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DOI: 10.1080/28352610.2026.2721073
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