Assessment of quality of survival in children with medulloblastoma and cerebellar astrocytoma

Abstract

To determine the quality of survival for children with posterior fossa tumors, comprehensive neuropsychological, behavioral, and academic assessment and physician ratings of functional status were obtained on 15 brain tumor patients (ages 6-19 years) at a median of 20 months post-diagnosis. More than 50% of the children (whether irradiated or not) experienced major problems in academic, motor, sensory, cognitive, and emotional function. All but two children were reported by teachers to be "slow workers," and four of 15 patients were able to maintain their school work in regular classes. Although 80% of the patients were rated by physicians as having "excellent" or "good" functional status, no relationship was found between these global ratings and psychometric measures. Although the affected site was the posterior fossa, deficits also involved higher cortical function. These findings indicate the need for further evaluation of treatment effects and the provision of intervention for survivors.

Neuropsychological sequelae of the treatment of children with medulloblastoma

“…The literature shows that childhood brain tumors below the tentorium bring a risk of cognitive morbidity, affecting a variety of higher cognitive functions. While MBs have the greater risk of neuropsychological impairment, non-malignant cerebellar tumors are also associated with motor, intellectual, and specific cognitive deficits [6,15].…”

“…Later research has supported the claim of progressive intellectual deterioration in radiated MB survivors [15,27,29,38,39]. Fortytwo percent of radiated MB survivors had intellectual deficits at 5 years post-treatment and 80% showed these deficits at 10 years post-treatment [27].…”

“…These include published norms for age peers [8], siblings or cousins [13,14], and children with posterior fossa tumors not requiring radiation or chemotherapy [5,15]. To date, we have found no published comparison of neuropsychological function in MB survivors and a normally-developing control group of age peers.…”

Child-related characteristics predicting subsequent health-related quality of life in 8- to 14-year-old children with and without cerebellar tumors: a prospective longitudinal study

“…9,12,14,18,20 Other previous studies have reported discrepant findings that may be attributable to heterogeneity with respect to participant age, tumor location, and interval from diagnosis or attrition bias. 2,11,41,42 The importance to HRQoL of neurological deficit, the functional consequences of which were captured in the motor and sensory function domain, was reflected in the predictive role of that domain by parent-report.…”

“…Poorer HRQoL has been associated with factors such as low IQ 11,12 and poor social, 9 physical, 13,14 behavioral, 11 and emotional functioning.…”