Late morbidity in long-term survivors of childhood brain tumors: a nationwide registry-based study in Finland

Gunn, Mirja Erika; Lähdesmäki, Tuire; Malila, Nea; Arola, Mikko; Grönroos, M; Matomäki, Jaakko; Lähteenmäki, Päivi

doi:10.1093/neuonc/nou321

Cited by 37 publications

(29 citation statements)

References 35 publications

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“…Radiation complications among 141 long-term survivors of retinoblastoma at the 5-year follow-up included non-proliferative maculopathy (25%), papillopathy (26%), cataract (31%), and glaucoma (11%) [ 198 ]. Ocular deficits are also common among survivors of CNS tumors [ 199 , 200 ]. Radiotherapy involving the eye is a risk factor for cataracts, legal blindness, dry eyes, and double vision [ 176 , 177 , 181 , 201 ].…”

Section: Neurosensory Deficitsmentioning

confidence: 99%

Impairments that Influence Physical Function among Survivors of Childhood Cancer

2015

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Children treated for cancer are at increased risk of developing chronic health conditions, some of which may manifest during or soon after treatment while others emerge many years after therapy. These health problems may limit physical performance and functional capacity, interfering with participation in work, social, and recreational activities. In this review, we discuss treatment-induced impairments in the endocrine, musculoskeletal, neurological, and cardiopulmonary systems and their influence on mobility and physical function. We found that cranial radiation at a young age was associated with a broad range of chronic conditions including obesity, short stature, low bone mineral density and neuromotor impairments. Anthracyclines and chest radiation are associated with both short and long-term cardiotoxicity. Although numerous chronic conditions are documented among individuals treated for childhood cancer, the impact of these conditions on mobility and function are not well characterized, with most studies limited to survivors of acute lymphoblastic leukemia and brain tumors. Moving forward, further research assessing the impact of chronic conditions on participation in work and social activities is required. Moreover, interventions to prevent or ameliorate the loss of physical function among children treated for cancer are likely to become an important area of survivorship research.

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Section: Neurosensory Deficitsmentioning

confidence: 99%

Impairments that Influence Physical Function among Survivors of Childhood Cancer

2015

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“…Central nervous system (CNS) cancers are the most frequently occurring solid tumors in children and most common cause of cancer deaths among children 0 to 14 years of age . Despite improvements in survival, morbidity remains high . Sleep disturbances are frequently reported during treatment and survivorship .…”

Section: Introductionmentioning

confidence: 99%

A pilot randomized controlled trial to improve sleep and fatigue in children with central nervous system tumors hospitalized for high‐dose chemotherapy

Rogers

Zhu

Ancoli‐Israel

et al. 2019

Pediatric Blood & Cancer

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Objectives To determine whether a sleep intervention compared with standard of care (SOC) was successful in preserving nighttime sleep in children with central nervous system cancers hospitalized for high‐dose chemotherapy (HDCT) and autologous stem cell rescue, and to explore associations between sleep and fatigue during treatment. Methods An unblinded, randomized, controlled, multicomponent intervention (NCT00666614) including evidence‐based cognitive and behavioral strategies to improve sleep was implemented in 33 children (age 4–12 years) and adolescents (age 13–19 years) during hospitalization. Children wore an actigraph to measure sleep and wake, and reported fatigue scores daily. Parents concurrently kept a sleep diary and reported fatigue scores for their children. Results The mean age was 9.5 ± 3.9 years, 81.8% were white, and 60.6% were male. Sleep in all children was seriously disturbed throughout the study. Children in the intervention group maintained their longest nighttime sleep across the study, while it declined in children receiving SOC (P = 0.009 for interaction). There were few other differences in sleep between groups. Controlling for age and baseline fatigue, higher nighttime activity score, and lower percent sleep were significantly associated with higher next‐day adolescent‐reported fatigue (P < 0.05); longest sleep was significantly positively associated with next‐day child‐reported fatigue (P = 0.018). Conclusion In this sample of children undergoing HDCT, a multicomponent sleep intervention modestly preserved nighttime sleep duration, although overall sleep was poor in both groups. Sleep is an integral component of health, and may influence outcomes of children receiving HDCT. Further investigation into methods of preserving sleep in children undergoing intensive cancer therapy is warranted.

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“…Longitudinal analysis of severe health problems such as those that require hospital admissions provides insight into the extent of chronic health conditions and healthcare consumption in CCS [7,8]. Previous research has shown that an increase in chronic health conditions among CCS translates into an increased risk of hospitalizations [9][10][11][12][13][14][15][16][17][18][19][20]. Several studies have thus provided important insight into the long-term morbidity in CCS using hospitalizations as a surrogate indicator [9][10][11][12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Risk and associated risk factors of hospitalization for specific health problems over time in childhood cancer survivors: a medical record linkage study

et al. 2017

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Childhood cancer survivors (CCS) experience higher hospitalization rates compared to the general population for neoplasms, circulatory diseases, endocrine/nutritional/metabolic diseases and eye disorders. We studied trends in hospitalization rates and associated patient and treatment‐specific risk factors for diagnosis subgroups among these four diseases. We performed medical record linkage of a ≥5‐year CCS cohort with national registers, and obtained a random reference sample matched on age, gender and calendar year per CCS. For each diagnosis subgroup we compared hospitalization rates and trends over time in CCS and the reference population. Further, we analyzed risk factors for hospitalizations within the four CCS diagnosis groups. We used multivariate Poisson regression for all models. We retrieved hospitalization data from 1382 CCS and 26,583 reference persons. CCS had increased hospitalization rates for almost all diagnosis subgroups examined. Hospitalization rates for endocrine/nutritional/metabolic diseases appeared to increase with longer time since primary cancer diagnosis up to 30 years after primary cancer diagnosis. Survivors initially treated with radiotherapy had increased hospitalization rates for neoplasms (P < 0.001), those initially treated with anthracyclines (2.5 [1.1–5.5]) and radiotherapy to thorax and/or abdomen (9.3 [2.4–36.6]) had increased hospitalization rates for diseases of the circulatory system, and those initially treated with radiotherapy to head and/or neck had increased hospitalization rates for endocrine/nutritional/metabolic diseases (6.7 [3.5–12.7]) and diseases of the eye (3.6 [1.5–8.9]). Our study highlights that long‐term health problems resulting in hospitalizations are still clinically relevant later in life of CCS. The identified treatment‐related risk factors associated with hospitalizations support targeted follow‐up care for these risk groups of CCS.

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Late morbidity in long-term survivors of childhood brain tumors: a nationwide registry-based study in Finland

Abstract: Pediatric BT survivors had significant neurocognitive consequences. This, together with the considerable risk for endocrine morbidity, will motivate us to organize systematic follow-up procedures for pediatric BT survivors.

Cited by 37 publications

References 35 publications

Impairments that Influence Physical Function among Survivors of Childhood Cancer

Impairments that Influence Physical Function among Survivors of Childhood Cancer

A pilot randomized controlled trial to improve sleep and fatigue in children with central nervous system tumors hospitalized for high‐dose chemotherapy

Risk and associated risk factors of hospitalization for specific health problems over time in childhood cancer survivors: a medical record linkage study

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