Quality of life in long-term survivors of CNS tumors of childhood and adolescence.

Abstract

Clinical reports of small numbers of pediatric brain tumor patients observed for brief periods suggest that long-term survivors continue to have major handicaps into adulthood. To quantify these late effects we interviewed 342 adults (or their proxies) who had CNS tumors diagnosed before the age of 20 between 1945 and 1974, survived at least 5 years, and reached 21 years of age. Survivors were 32 years old on average at follow-up. When compared with 479 matched siblings as controls. CNS tumor survivors were more likely to have died or to have become mentally incompetent sometime during the follow-up period. They were more likely to be at risk for such adverse outcomes as unemployment (odds ratio [OR], 10.8; 95% confidence interval [CI], 4.6 to 25.7], to have a health condition that affected their ability to work (OR, 5.9; CI, 3.7 to 9.4), to be unable to drive (OR, 28.8; CI, 6.9 to 119.9), or to describe their current health as poor (OR, 7.8; CI, 1.7 to 35.7). Unfavorable outcomes were more frequent in male survivors than in females, in those with supratentorial tumors compared with infratentorial ones, and in those who received radiation therapy. As clinicians consider improving therapies, they should anticipate late effects, such as those we observed, and attempt to target subgroups for interventions that may improve subsequent quality of life.

Marriage and parenthood among childhood cancer survivors: a report from the Italian AIEOP Off-Therapy Registry

“…6 Previous studies have considered marriage and parenthood as important indicators of psychological adjustment and achievement of social life goals by cancer survivors. 8,9 Most retrospective cohort and case-control studies conducted in the US, Canada and UK found marriage rates to be lower than expected, especially among survivors of childhood central nervous system (CNS) cancer, [9][10][11][12][13][14] and reported treatment-related fertility deficits. [15][16][17][18][19] In Italy, the only attempts to assess the experience of marriage and parenthood of childhood cancer survivors have been carried out in a single region situated in the North-West of the country (representing approximately 7% of the whole Italian population) using data of the Childhood Cancer Registry of Piedmont.…”

The comprehensive assessment of health status in survivors of childhood cancer: application to high-risk acute lymphoblastic leukaemia

“…An extensive literature has arisen on the medical costs of cure and the late effects of treatment (Blatt & Bleyer, 1989;Chessells et al, 1981;Green et al, 1991;Lansky et al, 1987; Levine & Hersh, 1982;Links & Stockwell, 1985;Maguire et al, 1987;Meadows et al, 1981Meadows et al, , 1980Mostow et al, 1991;Nesbit et al, 1979;O'Malley et al, 1979;Pastore et al, 1987;Wheeler et al, 1988;Whitt et al, 1984). This literature has identified a wide variety of seqpielae of ALL.…”

Proton Radiotherapy for Childhood Tumors: an Overview of Early Clinical Results

“…In particular, brain radiotherapy continues to pose a challenge to radiation oncologists because of the negative effects in neurocognitive, neuroendocrine function, and hearing loss. Neurocognitive damage is demonstrated by a development of deficits in several areas including mathematic ability, language, attention, memory, sleep-wake rhythm and Intelligence Quotient (IQ) [8]. Negative neurocognitive effects are the result of several factors including the brain tumor itself disrupting neurocognitive functioning, hydrocephalus, operative approaches and peri-operative complications.…”