Neurobehavioral Impairment in Pediatric Brain Tumor Survivors: A Meta-Analysis

Abstract

Purpose: The neurocognitive outcomes of pediatric brain tumor survivors have been extensively studied but the risk and predictors for neurobehavioral impairment are less clearly defined. We systematically analyzed the rates of emotional, psychosocial, and attention problems in pediatric brain tumor survivors. Methods: PubMed, Web of Science, Embase, Scopus, and Cochrane were searched for articles published between January 2012 to April 2022. Eligible studies reported neurobehavioral outcomes for PBTS aged 2 to <23 years with a brain tumor diagnosis before 18 years of age. A random-effect meta-analysis was performed in R. Results: The search yielded 1187 unique publications, of which 50 were included in the quantitative analysis. The estimated risk of having emotional, psychosocial, and attention problems were 15% (95%CI 10–20%), 12% (95%CI 9–16%), and 12% (95%CI 9–16%), respectively. PBTS were more likely to have emotional difficulties (Hedge’s g = 0.43 [95%CI 0.34–0.52]), psychosocial problems (Hedge’s g = 0.46 [95%CI 0.33–0.58]), and attention problems (Hedge’s g = 0.48 [95%CI 0.34–0.63]) compared to normal/healthy control subjects. There was no significant difference in the rates of neurobehavioral impairment between children with and without history of cranial radiotherapy. Conclusions: PBTS are at elevated risk of neurobehavioral impairment. Neurobehavioral monitoring should be considered as the standard of care for PBTS.

SCHOOL DIFFICULTIES in Children Cancer Survivors: A Narrative Review and a Teacher Point-of-View

“…During the post-treatment period, major learning disabilities are noted, with delays in passing grade exams, significant difficulties in numeracy and reading, and an impact on physical education [6,19,34]. Plus, a meta-analysis conducted by Wang et al in 2022 reported a higher rate of attention problems, emotional difficulties and psychosocial problems in pediatric brain tumor survivors [35]. Indeed, social inclusion with pairs remains a challenge for CCSs with CNS tumors, who are likely to have no close friends and therefore, can suffer from psychological distress [18,36].…”

Limited Research Investigating the Value of MRI in Predicting Future Cognitive Morbidity in Survivors of Paediatric Brain Tumours: A Call to Action for Clinical Neuroimaging Researchers

“…Many children with brain tumours experience neurocognitive effects at some point in their disease course, resulting in dysfunction in domains of cognition, emotion, and behaviour. The estimated risk for children with brain tumours of having emotional, psychosocial, and attention problems are 15%, 12% and 12% respectively, according to a recent meta-analysis [9]. Even at 10-year survival, these patients still demonstrate neuropsychological and psychosocial impairment across multiple domains [10].…”