Abstract
The percentage of children who survive childhood brain tumors is increasing. A number have neurological and other sequelae which impact on the quality of their survival. We reviewed long-term survivors using a standardized health status instrument. The mothers of 52 survivors of brain tumors were surveyed. Eight different aspects (attributes) of health status were scored. The first 6 of these attributes were scored in a health status index (HSI) developed at McMaster University. Subgroup analysis was performed. Limitation in the quality of life was found in one of the 8 attributes in all but 2 of the subjects. The health status index (HSI) score using the first 6 attributes of this survey had a median of 0.73 (range 0.16–1.00). This score is lower than that found in previously surveyed survivors of leukemia or other childhood cancers. Examination of age at diagnosis, extent of surgery, sex and therapeutic modalities used showed no correlation with HSI score. Those with supratentorial astrocytomas had a lower HSI score (0.65) than those with infratentorial astrocytomas (0.85) (p=0.05). Children with craniopharyngiomas had a poor score (0.64). This survey shows that the survivors of brain tumors have an appreciable burden of morbidity. Most have deficits in health status that affect many areas of their lives. Apart from site of the primary tumor, there was little correlation between subgroups studied and health status. The health status of children who survive brain tumors is lower than that of survivors of other childhood malignancies.
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Barr RD, Feeny D, Furlong W, Weitzman S, Torrance GW: Apreference-based approach to health-related quality of life for children with cancer. Inter J Pediatr Hematol Oncol 2: 305–315, 1995
Aaronson NK: Assessing the quality of life in patients in cancer clinical trials: common problems and common-sense solutions. Eur J Cancer 28A: 1304–1307, 1992
van Kippenberg FC, de Haes JC: Measuring the quality of life in cancer patients: Psychomimetic properties of instruments. J Clin Epidemiol 41: 1043–1053, 1988
Apajasalo M, Sintonen H, Siimes MA, Hovi L, Holmberg C, Boyd H, Makela A, Rautonen J: Health – related quality of life of adults surviving malignancies in childhood. Eur J Cancer 32: 1354–1358, 1996
Mostow EN, Byrne J, Connelly RR, Mulvihill JJ: Quality of life in long-term survivors of CNS tumors of childhood and adolescence. J Clin Oncol 9: 592–599, 1991
Lannering B, Marky I, Lundberg A, Olsson El: Long-term sequelae after pediatric brain tumors: Their effect on disability and quality of life. Med Pediatr Oncol 18: 304–310, 1990
Packer RJ, Meadows AT, Rorke LB, Goldwein JL, D'Angio G: Long-term sequelae of cancer treatment on the central nervous system in childhood. Med Pediatr Oncol 15: 241–253, 1987
Martinez-Climent J, Castel Sanchez V, Esquembre C, Verquer Miralles A, Ferris Jortajuda J: Scale for assessing quality of life of children survivors of cranial posterior fossa tumors. J Neuro-Oncol 22: 67–76, 1994
Donavan K, Sanson-Fisher RW, Redman S: Measuring the quality of life in cancer patients. J Clin Oncol 7: 959, 1989
Feeny D, FurlongW, Barr RD, TorranceGW, Rosenbaum P, Weitzman S: A comprehensive multi-attribute system for classifying the health status of survivors of childhood cancer. J Clin Oncol 10: 923–928, 1989
Feeney D, TorranceGW, Furlong WJ: Health utilities index. In: Spicer B (ed) 'Quality of Life and Pharmacoeconomics in Clinical Trials'. 2nd ed. Philadelphia: Lippincott-Raven, 1996, pp 239–252
Torrance GW, Boyle MH, Horwood SP: Application of multi-attribute utility theory to measure social preferences for health states. Operations Research 30: 1043–1069, 1992
Cadman D, Goldsmith C, TorranceGW, Boyle MH, Furlong W: Development of a health status index for Ontario children. Final report to the Ontario Ministry of Health on research grant DM648 (00633). Hamilton, Ontario: McMaster University, 1986
Cadman D, Goldsmith C, Bashim P: Values, preferences and decisions in the care of children with developmental disabilities. Dev Behav Pediatr 5: 60–64, 1984
Billson AL, Walker DA: Assessment of health status in survivors of cancer. Arch Dis Child 70: 200–204, 1994
Feeny D, Leiper A, Barr RD, Furlong W, Torrance GW, Rosenbaum P, Weitzman S: The comprehensive assessment of health status in survivors of childhood cancer: application to high-risk acute lymphoblastic leukaemia. B J Cancer 67: 1047–1052, 1993
Bradlyn AS, Ritchey AK, Harris CV, (Ki) Moore IM, O'Brien RT, Parsons SK, Patterson K, Pollock BH: Quality of life research in pediatric oncology. Cancer 78: 1333–1339, 1996
Osoba D: Lessons learned from measuring health-related quality of life in oncology. J Clin Oncol 12: 608–616, 1994
Achenbach TM, McConaughy SH, Howell CT: Child/ adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity. Psychol Bull 101: 213–232, 1987
Stahnke N, Grubel G, Lagenstein I, Willing RP: Long-term follow-up of children with craniopharyngioma. Eur J Pediatr 142: 179–185, 1984
Duffner PK, Cohen ME (eds): Craniopharyngiomas. In 'Brain Tumors in Children' 2nd ed. Raven Press Books LTD, New York, 1994
Duffner PK, Cohen ME: Long-term consequences of CNS treatment for childhood cancer. II: Clinical Consequences. Pediatr Neurol 7: 237–242, 1991
Syndikus I, Tait D, Ashley S, Jannoun L: Long-term followup of young children with brain tumors after irradiation. Int J Radiat Oncol Biol Phys 30: 781–787, 1994
Eiser C: Intellectual abilities amongst survivors of childhood leukemia as a function of CNS irradiation. Arch Dis Child53: 391–395, 1978
Eiser C, Lansdown R: Retrospective study of intellectual development in children treated for acute lymphoblastic leukemia. Arch Dis Child 52: 525–529, 1977
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Foreman, N.K., Faestel, P.M., Pearson, J. et al. Health Status in 52 Long-term Survivors of Pediatric Brain Tumors. J Neurooncol 41, 47–53 (1999). https://doi.org/10.1023/A:1006145724500
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DOI: https://doi.org/10.1023/A:1006145724500