Quality of Life and Symptoms in Pediatric Brain Tumor Survivors

Abstract

Little is known about the quality of life of children and youth under the age of 20 who have completed treatment for a pediatric brain tumor. This systematic review was conducted to (a) describe the health-related quality of life (HRQL) outcomes in pediatric brain tumor survivors, (b) identify instruments used to measure HRQL, and (c) determine the relationship between symptoms and HRQL. Using a systematic search and review methodology, databases searched included CINAHL, Medline, Embase, and PsycInfo. No date restrictions were used. Search results elicited 485 articles, of which16 met the inclusion criteria. Compared with their healthy peers, pediatric brain tumor survivors did worse on most measures of physical, psychosocial, social, and cognitive domains of HRQL. Compared with other cancer patients, survivors scored themselves significantly lower on the Pediatric Quality of Life Inventory (PedsQL) social functioning scale, and parents of brain tumor survivors reported lower PedsQL social and total functioning scores for their children. Other variables that were associated with decreased HRQL were degree of hypothalamic tumor involvement, osteopenia, need for special education, older age at diagnosis, greater than 1 year since treatment, and radiation treatment. In these studies, pediatric brain tumor survivors fared worse compared with other cancer survivors or healthy peers on several HRQL domains. Only 3 studies explored the relationship between symptoms, including pain or fatigue, and HRQL in pediatric brain tumor survivors. The relationship between symptoms and HRQL was not well elucidated. More research is needed to explore the multidimensional symptom experience and HRQL outcomes in pediatric brain tumor survivors.

Quality of Life in Children With Advanced Cancer: A Report From the PediQUEST Study

“…Fewer studies have included the voice of the child (30–35). Likewise, prior studies have focused on survivors (26, 36) or patients receiving therapy for cancers which are expected to be cured (23, 25, 33); HRQOL in children with advanced cancer has seldom been described (37–39). Deeper knowledge about patient-reported HRQOL in this group is needed to alleviate suffering and promote patient (and family) well-being.…”

“…Three recent systematic reviews identified a wide array of variables associated with HRQOL in children with cancer (26, 36, 40). Factors consistently associated with poor HRQOL include concurrent cancer therapy (41–45), higher treatment-intensity (23, 46, 47), poor prognosis or history of relapse (23, 26), older age (25, 36, 40), cancer-type (where patients with sarcomas or brain tumors have poorer HRQOL) (36, 40, 45, 46), and female sex (23, 25, 40, 44).…”

“…Factors consistently associated with poor HRQOL include concurrent cancer therapy (41–45), higher treatment-intensity (23, 46, 47), poor prognosis or history of relapse (23, 26), older age (25, 36, 40), cancer-type (where patients with sarcomas or brain tumors have poorer HRQOL) (36, 40, 45, 46), and female sex (23, 25, 40, 44). While existing results may help identify patients at risk for poor HRQOL (23), immediately modifiable factors of HRQOL, such as symptoms, have been insufficiently described (26, 36). …”

Executive dysfunction is associated with poorer health-related quality of life in pediatric brain tumor survivors

“…A recent review of the HRQoL literature in children with BT identified only 16 relevant studies (Macartney, Harrison, VanDenKerkhof, et al, 2014). BT survivors were rated lower across a number of HRQoL areas relative to healthy peers and children with other types of cancer.…”

Quality of Life in Pediatric Cancer Survivors: Contributions of Parental Distress and Psychosocial Family Risk

“…It is also possible that covariates (i.e., length of remission, type of cancer) that were not included in the current study may have influenced the results. For example, compared with other cancer survivors, children treated for brain tumours rate their hrql as lower, particularly on the social functioning subscales, as do their parents 38 . Future research should examine whether children who have experienced different cancers may be especially vulnerable to psychosocial family risk.…”