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Ajithkumar T, Avanzo M, Yorke E, Tsang DS, Milano MT, Olch AJ, Merchant TE, Dieckmann K, Mahajan A, Fuji H, Paulino AC, Timmermann B, Marks LB, Bentzen SM, Jackson A, Constine LS. Brain and Brain Stem Necrosis After Reirradiation for Recurrent Childhood Primary Central Nervous System Tumors: A PENTEC Comprehensive Review. Int J Radiat Oncol Biol Phys 2024; 119:655-668. [PMID: 38300187 DOI: 10.1016/j.ijrobp.2023.12.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 12/19/2023] [Accepted: 12/26/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE Reirradiation is increasingly used in children and adolescents/young adults (AYA) with recurrent primary central nervous system tumors. The Pediatric Normal Tissue Effects in the Clinic (PENTEC) reirradiation task force aimed to quantify risks of brain and brain stem necrosis after reirradiation. METHODS AND MATERIALS A systematic literature search using the PubMed and Cochrane databases for peer-reviewed articles from 1975 to 2021 identified 92 studies on reirradiation for recurrent tumors in children/AYA. Seventeen studies representing 449 patients who reported brain and brain stem necrosis after reirradiation contained sufficient data for analysis. While all 17 studies described techniques and doses used for reirradiation, they lacked essential details on clinically significant dose-volume metrics necessary for dose-response modeling on late effects. We, therefore, estimated incidences of necrosis with an exact 95% CI and qualitatively described data. Results from multiple studies were pooled by taking the weighted average of the reported crude rates from individual studies. RESULTS Treated cancers included ependymoma (n = 279 patients; 7 studies), medulloblastoma (n = 98 patients; 6 studies), any CNS tumors (n = 62 patients; 3 studies), and supratentorial high-grade gliomas (n = 10 patients; 1 study). The median interval between initial and reirradiation was 2.3 years (range, 1.2-4.75 years). The median cumulative prescription dose in equivalent dose in 2-Gy fractions (EQD22; assuming α/β value = 2 Gy) was 103.8 Gy (range, 55.8-141.3 Gy). Among 449 reirradiated children/AYA, 22 (4.9%; 95% CI, 3.1%-7.3%) developed brain necrosis and 14 (3.1%; 95% CI, 1.7%-5.2%) developed brain stem necrosis with a weighted median follow-up of 1.6 years (range, 0.5-7.4 years). The median cumulative prescription EQD22 was 111.4 Gy (range, 55.8-141.3 Gy) for development of any necrosis, 107.7 Gy (range, 55.8-141.3 Gy) for brain necrosis, and 112.1 Gy (range, 100.2-117 Gy) for brain stem necrosis. The median latent period between reirradiation and the development of necrosis was 5.7 months (range, 4.3-24 months). Though there were more events among children/AYA undergoing hypofractionated versus conventionally fractionated reirradiation, the differences were not statistically significant (P = .46). CONCLUSIONS Existing reports suggest that in children/AYA with recurrent brain tumors, reirradiation with a total EQD22 of about 112 Gy is associated with an approximate 5% to 7% incidence of brain/brain stem necrosis after a median follow-up of 1.6 years (with the initial course of radiation therapy being given with conventional prescription doses of ≤2 Gy per fraction and the second course with variable fractionations). We recommend a uniform approach for reporting dosimetric endpoints to derive robust predictive models of late toxicities following reirradiation.
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Affiliation(s)
- Thankamma Ajithkumar
- Department of Oncology, Cambridge University Hospitals, Cambridge, United Kingdom.
| | - Michele Avanzo
- Division of Medical Physics, Centro di Riferimento Oncologico Aviano IRCCS, Aviano, Italy
| | - Ellen Yorke
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Derek S Tsang
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Michael T Milano
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York
| | - Arthur J Olch
- Department of Radiation Oncology and Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Thomas E Merchant
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Karin Dieckmann
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Anita Mahajan
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Hiroshi Fuji
- National Center for Child Health and Development, Tokyo, Japan
| | - Arnold C Paulino
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Beate Timmermann
- Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen, West German Cancer Center, Essen, Germany
| | - Lawrence B Marks
- Department of Radiation Oncology and Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Soren M Bentzen
- Division of Biostatistics and Bioinformatics, Department of Radiation Oncology, and University of Maryland Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Andrew Jackson
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Louis S Constine
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York; Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
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Traunwieser T, Loos E, Ottensmeier H, Gastberger K, Nemes K, Mynarek M, Bison B, Kandels D, Neumayer P, Neumann-Holbeck A, Lüttich P, Baust K, Faulstich-Ritter K, John R, Kreisch A, Landmann J, Manteufel E, Nest A, Prüfe J, Schubert L, Stamm W, Timmermann B, Gerss J, Rutkowski S, Schlegel PG, Eyrich M, Gnekow AK, Frühwald MC. Survivors of infant atypical teratoid/rhabdoid tumors present with severely impaired cognitive functions especially for fluid intelligence and visual processing: data from the German brain tumor studies. Pediatr Blood Cancer 2024; 71:e30910. [PMID: 38342954 DOI: 10.1002/pbc.30910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/12/2024] [Accepted: 01/23/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND The contribution of tumor type, multimodal treatment, and other patient-related factors upon long-term cognitive sequelae in infant brain tumor survivors remains undefined. We add our retrospective analysis of neuropsychological and quality of survival (QoS) outcome data of survivors of atypical teratoid/rhabdoid tumors (ATRT) and extracranial malignant rhabdoid tumors of the soft tissues (eMRT) and kidneys (RTK) treated within the same framework. Neuropsychological data from children with ATRT were compared to data from children with non-irradiated low-grade glioma (LGG). PATIENTS AND METHODS Following surgery, patients (0-36 months at diagnosis) had received radio-chemotherapy (up to 54 Gy; ATRT: n = 13; eMRT/RTK: n = 7), chemotherapy only (LGG: n = 4; eMRT/RTK: n = 1) or had been observed (LGG: n = 11). Neuropsychological evaluation employing comparable tests was performed at median 6.8 years (ATRT), 6.6 years (eMRT/RTK), and 5.2 years (LGG) post diagnosis. RESULTS We detected sequelae in various domains for all tumor types. Group comparison showed impairments, specifically in fluid intelligence (p = .041; d = 1.11) and visual processing (p = .001; d = 2.09) in ATRT patients when compared to LGG patients. Results for psychomotor speed and attention abilities were significantly below the norm for both groups (p < .001-.019; d = 0.79-1.90). Diagnosis predicted impairments of cognitive outcome, while sex- and age-related variables did not. QoS outcome for all rhabdoid patients displayed impairments mainly in social (p = .008; d = 0.74) and school functioning (p = .048; d = 0.67), as well as lower overall scores in psychosocial functioning (p = .023; d = 0.78) and quality of life (p = .006; d = 0.79) compared to healthy controls. CONCLUSION Survivors of infant ATRT experience various late effects in cognition and QoS following multimodal treatment, while infant LGG patients without radiotherapy demonstrated comparable impairments in psychomotor and attention abilities. Early onset and multimodal treatment of rhabdoid tumors require close monitoring of neuropsychological and QoS sequelae.
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Affiliation(s)
- Thomas Traunwieser
- Swabian Children's Cancer Center, Pediatrics and Adolescent Medicine, University Hospital Augsburg, Augsburg, Germany
- Bavarian Cancer Research Center, Augsburg, Germany
| | - Elena Loos
- Swabian Children's Cancer Center, Pediatrics and Adolescent Medicine, University Hospital Augsburg, Augsburg, Germany
- Bavarian Cancer Research Center, Augsburg, Germany
| | - Holger Ottensmeier
- Department of Pediatric Hematology and Oncology, University Hospital Würzburg, Würzburg, Germany
| | - Katharina Gastberger
- Swabian Children's Cancer Center, Pediatrics and Adolescent Medicine, University Hospital Augsburg, Augsburg, Germany
- Bavarian Cancer Research Center, Augsburg, Germany
| | - Karolina Nemes
- Swabian Children's Cancer Center, Pediatrics and Adolescent Medicine, University Hospital Augsburg, Augsburg, Germany
- Bavarian Cancer Research Center, Augsburg, Germany
| | - Martin Mynarek
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
- Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Brigitte Bison
- Diagnostic and Interventional Neuroradiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Neuroradiological Reference Center for the Pediatric Brain Tumor (HIT) Studies of the German Society of Pediatric Oncology and Hematology, Faculty of Medicine, University Augsburg, Augsburg, Germany
| | - Daniela Kandels
- Swabian Children's Cancer Center, Pediatrics and Adolescent Medicine, University Hospital Augsburg, Augsburg, Germany
- Bavarian Cancer Research Center, Augsburg, Germany
| | - Petra Neumayer
- Swabian Children's Cancer Center, Pediatrics and Adolescent Medicine, University Hospital Augsburg, Augsburg, Germany
- Bavarian Cancer Research Center, Augsburg, Germany
| | - Anne Neumann-Holbeck
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Peggy Lüttich
- Hopp Children's Cancer Center Heidelberg (KiTZ), German Cancer Research Center (DKFZ) and Heidelberg, University Hospital, Heidelberg, Germany
| | - Katja Baust
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | | | - Rainer John
- Department Pediatric Hematology and Oncology, Center for Chronically Sick Children (SPZ), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andrea Kreisch
- Department of Pediatrics, University Hospital and Medical Faculty Carl-Gustav-Carus, Technische Universität Dresden, Dresden, Germany
| | - Judyta Landmann
- Department of Paediatric Haematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Eva Manteufel
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Justus-Liebig University of Giessen, Giessen, Germany
| | - Alexandra Nest
- Department of Pediatric Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Jenny Prüfe
- Department of Pediatric Hematology and Oncology, Pediatrics III, Essen University Hospital, Essen, Germany
| | - Lisa Schubert
- Department of Pediatric Hematology and Oncology, University Hospital Würzburg, Würzburg, Germany
| | - Walther Stamm
- Department of Pediatric Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Beate Timmermann
- Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen (WPE), West German Cancer Center (WTZ), German Cancer Consortium (DKTK), Essen, Germany
| | - Joachim Gerss
- Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Paul-Gerhardt Schlegel
- Department of Pediatric Hematology and Oncology, University Hospital Würzburg, Würzburg, Germany
| | - Matthias Eyrich
- Department of Pediatric Hematology and Oncology, University Hospital Würzburg, Würzburg, Germany
| | - Astrid K Gnekow
- Swabian Children's Cancer Center, Pediatrics and Adolescent Medicine, University Hospital Augsburg, Augsburg, Germany
- Bavarian Cancer Research Center, Augsburg, Germany
| | - Michael C Frühwald
- Swabian Children's Cancer Center, Pediatrics and Adolescent Medicine, University Hospital Augsburg, Augsburg, Germany
- Bavarian Cancer Research Center, Augsburg, Germany
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Brandt AE, Rø TB, Finnanger TG, Hypher RE, Lien E, Lund B, Catroppa C, Andersson S, Risnes K, Stubberud J. Intelligence and executive function are associated with age at insult, time post-insult, and disability following chronic pediatric acquired brain injury. Front Neurol 2024; 14:1192623. [PMID: 38249741 PMCID: PMC10796693 DOI: 10.3389/fneur.2023.1192623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 12/05/2023] [Indexed: 01/23/2024] Open
Abstract
Background Pediatric acquired brain injury (pABI) profoundly affects cognitive functions, encompassing IQ and executive functions (EFs). Particularly, young age at insult may lead to persistent and debilitating deficits, affecting daily-life functioning negatively. This study delves into the intricate interplay of age at insult, time post-insult, and their associations with IQ and EFs during chronic (>1 year) pABI. Additionally, we investigate cognitive performance across different levels of global function, recognizing the multifaceted nature of developmental factors influencing outcomes. Methods Drawing upon insult data and baseline information analyzing secondary outcomes from a multicenter RCT, including comprehensive medical and neuropsychological assessments of participants aged 10 to 17 years with pABI and parent-reported executive dysfunctions. The study examined associations between age at insult (early, EI; ≤7y vs. late, LI; > 7y) and time post-insult with IQ and EFs (updating, shifting, inhibition, and executive attention). Additionally, utilizing the Pediatric Glasgow Outcome Scale-Extended, we explored cognitive performance across levels of global functioning. Results Seventy-six participants, median 8 years at insult and 5 years post-insult, predominantly exhibiting moderate disability (n = 38), were included. Notably, participants with LI demonstrated superior IQ, executive attention, and shifting compared to EI, [adjusted mean differences with 95% Confidence Intervals (CIs); 7.9 (1.4, 14.4), 2.48 (0.71, 4.24) and 1.73 (0.03, 3.43), respectively]. Conversely, extended post-insult duration was associated with diminished performances, evident in mean differences with 95% CIs for IQ, updating, shifting, and executive attention compared to 1-2 years post-insult [-11.1 (-20.4, -1.7), -8.4 (-16.7, -0.1), -2.6 (-4.4, -0.7), -2.9 (-4.5, -1.2), -3.8 (-6.4, -1.3), -2.6 (-5.0, -0.3), and -3.2 (-5.7, -0.8)]. Global function exhibited a robust relationship with IQ and EFs. Conclusion Early insults and prolonged post-insult durations impose lasting tribulations in chronic pABI. While confirmation through larger studies is needed, these findings carry clinical implications, underscoring the importance of vigilance regarding early insults. Moreover, they dispel the notion that children fully recover from pABI; instead, they advocate equitable rehabilitation offerings for pABI, tailored to address cognitive functions, recognizing their pivotal role in achieving independence and participation in society. Incorporating disability screening in long-term follow-up assessments may prove beneficial.
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Affiliation(s)
- Anne Elisabeth Brandt
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Torstein B. Rø
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Torun G. Finnanger
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ruth E. Hypher
- Department of Clinical Neurosciences for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Espen Lien
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Bendik Lund
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Cathy Catroppa
- Brain and Mind, Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Department of Psychology, Royal Children’s Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | | | - Kari Risnes
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jan Stubberud
- Department of Clinical Neurosciences for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
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4
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Leenders AEM, Kremer-Hooft van Huijsduijnen E, Robalo B, van Male R, De Luca A, Kemps R, Hoving E, Lequin MH, Grootenhuis MA, Partanen M. Unraveling the relations between post-traumatic stress symptoms, neurocognitive functioning, and limbic white matter in pediatric brain tumor patients. Neurooncol Adv 2024; 6:vdae026. [PMID: 38476931 PMCID: PMC10929421 DOI: 10.1093/noajnl/vdae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
Background Pediatric brain tumor patients are at risk of developing neurocognitive impairments and associated white matter alterations. In other populations, post-traumatic stress symptoms (PTSS) impact cognition and white matter. This study aims to investigate the effect of PTSS on neurocognitive functioning and limbic white matter in pediatric brain tumor patients. Methods Sixty-six patients (6-16 years) completed neuropsychological assessment and brain MRI (1-year post-diagnosis) and parents completed PTSS proxy questionnaires (CRIES-13; 1-3 months and 1-year post-diagnosis). Mean Z-scores and percentage impaired (>1SD) for attention, processing speed, executive functioning, and memory were compared to normscores (t-tests, chi-square tests). Multi-shell diffusion MRI data were analyzed for white matter tractography (fractional anisotropy/axial diffusivity). Effects of PTSS on neurocognition and white matter were explored with linear regression models (FDR correction for multiple testing), including age at diagnosis, treatment intensity, and tumor location as covariates. Neurocognition and limbic white matter associations were explored with correlations. Results Attention (M = -0.49, 33% impaired; P < .05) and processing speed (M = -0.57, 34% impaired; P < .05) were significantly lower than healthy peers. PTSS was associated with poorer processing speed (β = -0.64, P < .01). Treatment intensity, age at diagnosis, and tumor location, but not PTSS, were associated with limbic white matter metrics. Neurocognition and white matter metrics were not associated. Conclusions Higher PTSS was associated with poorer processing speed, highlighting the need for monitoring, and timely referrals to optimize psychological well-being and neurocognitive functioning. Future research should focus on longitudinal follow-up and explore the impact of PTSS interventions on neurocognitive performance.
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Affiliation(s)
- Anne E M Leenders
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Bruno Robalo
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Rosa van Male
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Rachèl Kemps
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Eelco Hoving
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Maarten H Lequin
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Marita Partanen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Troudi A, Tensaouti F, Cabarrou B, Arribarat G, Pollidoro L, Péran P, Sevely A, Roques M, Chaix Y, Bertozzi AI, Gambart M, Ducassou A, Baudou E, Laprie A. A Prospective Study of Arterial Spin Labelling in Paediatric Posterior Fossa Tumour Survivors: A Correlation with Neurocognitive Impairment. Clin Oncol (R Coll Radiol) 2024; 36:56-64. [PMID: 37805352 DOI: 10.1016/j.clon.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/25/2023] [Indexed: 10/09/2023]
Abstract
AIMS Posterior fossa tumours (PFTs), which account for two-thirds of paediatric brain tumours, are successfully treated in about 70% of patients, but most survivors experience long-term cognitive impairment. We evaluated arterial spin labelling (ASL), a common, non-invasive magnetic resonance imaging (MRI) technique, as a biomarker of cognitive impairment in a paediatric PFT survivor population. MATERIALS AND METHODS Sixty participants were prospectively analysed. PFT survivors were at least 5 years post-treatment and had been treated as appropriate for their age and type of tumour. Group 1 had received radiotherapy and Group 2 had not. Group 3 were healthy controls matched to Group 1 for age, sex and handedness. All participants underwent cognitive assessment and multimodal MRI, including an ASL perfusion sequence. We used semi-quantitative ASL methods to assess differences in mean perfusion in the thalamus, caudate, putamen and hippocampus. RESULTS Statistically, no significant associations between cognitive data and radiation doses were identified. Compared with healthy controls, Group 1 patients had significantly lower overall mean perfusion values (20-30% lower, depending on the cerebral structure) and Group 2 had slightly lower mean perfusion values (5-10% lower). Perfusion values did not correlate with total prescribed irradiation doses nor with doses received by different cerebral structures. Episodic and semantic memory test scores were significantly lower in Group 1 and correlated with lower mean absolute perfusion values in the hippocampus (P < 0.04). CONCLUSIONS These preliminary results indicate that radiotherapy affects the perfusion of specific cerebral structures and identify perfusion as a potential biomarker of hippocampus-dependent memory deficit.
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Affiliation(s)
- A Troudi
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - F Tensaouti
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Radiation Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France.
| | - B Cabarrou
- Biostatistics & Health Data Science Unit, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, Toulouse, France
| | - G Arribarat
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - L Pollidoro
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Radiology Department, Toulouse University Hospital, Toulouse, France
| | - P Péran
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - A Sevely
- Radiology Department, Toulouse University Hospital, Toulouse, France
| | - M Roques
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Radiology Department, Toulouse University Hospital, Toulouse, France
| | - Y Chaix
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - A-I Bertozzi
- Pediatric Oncology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - M Gambart
- Pediatric Oncology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - A Ducassou
- Radiation Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - E Baudou
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - A Laprie
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Radiation Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
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Bucaille A, Jarry C, Allard J, Brosseau-Beauvir A, Ropars J, Brochard S, Peudenier S, Roy A. Intelligence and Executive Functions: A Comprehensive Assessment of Intellectually Gifted Children. Arch Clin Neuropsychol 2023; 38:1035-1046. [PMID: 36852774 DOI: 10.1093/arclin/acad021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2023] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE Executive functions (EFs) play a key role in cognitive and behavioral functioning. Their multiple forms and implications for daily life behaviors mean they are sometimes equated with intelligence. Several elements even suggest that intellectually gifted children (IGC) may present better executive functioning than typical developing children (TDC, children with intelligence in the average range). However, no study has ever completely tested this hypothesis by a comprehensive assessment of EFs in IGC. METHOD Results of 30 IGC and 35 TDC aged from 6 to 16 years old were compared through a comprehensive assessment of EFs (inhibition, flexibility, and planning), comprising performance-based and daily life measures. RESULTS IGC did not differ from TDC in EF performance-based measures. However, they scored higher in parents' and some teachers' ratings, suggesting higher indicators of difficulties in daily life. CONCLUSIONS Contrary to expectations, high intellectual level does not appear to be associated with superior EFs. Surprisingly, parents and teachers of IGC reported more complaints about their executive functioning in everyday life. We put forward different hypotheses to explain this contrast. Further research is needed to better understand this phenomenon, in which neuropsychology has a fundamental role to play.
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Affiliation(s)
- A Bucaille
- Learning Disabilities Reference Center, Brest University Hospital, Brest Cedex, France
- Psychology Laboratory of the Pays de la Loire (EA 4638), University of Angers, Angers, France
| | - C Jarry
- Psychology Laboratory of the Pays de la Loire (EA 4638), University of Angers, Angers, France
| | - J Allard
- Coordination Platform for Neurodevelopmental Disorders, Saint-Nazaire, France
| | - A Brosseau-Beauvir
- Learning Disabilities Reference Center, Brest University Hospital, Brest Cedex, France
- Pediatric Rehabilitation Department, ILDYS Foundation, Brest Cedex 2, France
| | - J Ropars
- Laboratory of Medical Information Processing (LaTIM), INSERM UMR 1101, Brest Cedex, France
- Pediatrics Department, Brest University Hospital, Brest, France
| | - S Brochard
- Pediatric Rehabilitation Department, ILDYS Foundation, Brest Cedex 2, France
- Laboratory of Medical Information Processing (LaTIM), INSERM UMR 1101, Brest Cedex, France
- Pediatric Rehabilitation Department, Brest University Hospital, Brest, France
| | - S Peudenier
- Learning Disabilities Reference Center, Brest University Hospital, Brest Cedex, France
- Pediatrics Department, Brest University Hospital, Brest, France
| | - A Roy
- Psychology Laboratory of the Pays de la Loire (EA 4638), University of Angers, Angers, France
- Learning Disabilities Reference Center, Nantes University Hospital, Nantes Cedex 1, France
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Rüther M, Hagan AJ, Verity SJ. The role of CNS tumor location in health-related quality of life outcomes: A systematic review of supratentorial vs infratentorial tumors in childhood survivorship. APPLIED NEUROPSYCHOLOGY. CHILD 2023:1-20. [PMID: 37851360 DOI: 10.1080/21622965.2023.2268776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Continued advancements in the treatment of pediatric brain tumors have resulted in a growing proportion of children surviving previously incurable diagnoses. However, survivors of pediatric brain tumors show reduced Health-Related Quality of Life (HRQoL) compared to healthy populations and non-CNS childhood cancer survivors. This review systematically evaluates the existing literature on the influence of supratentorial and infratentorial brain tumor locations on Health-Related Quality of Life outcomes in survivors of pediatric brain tumors. Five electronic databases were searched for relevant articles published between their inception and January 2022. A purpose-developed evaluative tool was constructed to assess the quality of eligible studies. 16 of the 5270 identified articles were included in this review (n = 1391). This review found little evidence relating to the impact of brain tumor location on HRQoL, with only one study finding a significant difference between supratentorial and infratentorial tumor survivors. Key limitations of the current evidence include poor statistical reporting, ambiguous construct definitions, and insufficient adjustment for confounds. Findings from this review show that recovery from a pediatric brain tumor extends beyond recovery post-treatment and that further study into the factors influencing survivor HRQoL, including the influence of tumor location, is necessary.
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Affiliation(s)
- Marike Rüther
- Department of Paediatric Health Psychology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - Alexander James Hagan
- Department of Paediatric Health Psychology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - Sarah J Verity
- Department of Paediatric Health Psychology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
- Newcastle University Centre for Cancer, Newcastle upon Tyne, UK
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Bonanno M, Bourque CJ, Robichaud LA, Levesque A, Lacoste-Julien A, Rondeau É, Dubé É, Leblanc M, Bertrand MC, Provost C, Desjardins L, Sultan S. Prioritizing Solutions and Improving Resources among Young Pediatric Brain Tumor Survivors: Results of an Online Survey. Curr Oncol 2023; 30:8586-8601. [PMID: 37754538 PMCID: PMC10527929 DOI: 10.3390/curroncol30090623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/14/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023] Open
Abstract
Pediatric Brain Tumor Survivors (PBTS) often experience social, academic and employment difficulties during aftercare. Despite their needs, they often do not use the services available to them. Following a previous qualitative study, we formulated solutions to help support PBTS return to daily activities after treatment completion. The present study aims to confirm and prioritize these solutions with a larger sample. We used a mixed-methods survey with 68 participants (43 survivors, 25 parents, PBTS' age: 15-39 years). Firstly, we collected information about health condition, and school/work experience in aftercare. Then, we asked participants to prioritize the previously identified solutions using Likert scales and open-ended questions. We used descriptive and inferential statistics to analyze data, and qualitative information to support participants' responses. Participants prioritized the need for evaluation, counseling, and follow-up by health professionals to better understand their post-treatment needs, obtain help to access adapted services, and receive information about resources at school/work. Responses to open-ended questions highlighted major challenges regarding the implementation of professionals' recommendations at school/work and the need for timely interventions. These results will help refine solutions for PBTS and provide key elements for future implementation. Translating these priorities into action will need further work involving professionals and decision makers.
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Affiliation(s)
- Marco Bonanno
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, QC H3T 1C5, Canada
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | | | - Lye-Ann Robichaud
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
- Department of Psychology, Université de Montréal, Montreal, QC H2V 2S9, Canada
| | - Ariane Levesque
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
- Department of Psychology, Université de Montréal, Montreal, QC H2V 2S9, Canada
| | - Ariane Lacoste-Julien
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | - Émélie Rondeau
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | - Émilie Dubé
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | - Michelle Leblanc
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | - Marie-Claude Bertrand
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, QC H3T 1C5, Canada
| | - Carole Provost
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, QC H3T 1C5, Canada
| | - Leandra Desjardins
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
- CHU Sainte-Justine Research Centre, Montreal, QC H3T 1C5, Canada
| | - Serge Sultan
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
- Department of Psychology, Université de Montréal, Montreal, QC H2V 2S9, Canada
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9
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Brown AL, Sok P, Raghubar KP, Lupo PJ, Richard MA, Morrison AC, Yang JJ, Stewart CF, Okcu MF, Chintagumpala MM, Gajjar A, Kahalley LS, Conklin H, Scheurer ME. Genetic susceptibility to cognitive decline following craniospinal irradiation for pediatric central nervous system tumors. Neuro Oncol 2023; 25:1698-1708. [PMID: 37038335 PMCID: PMC10479777 DOI: 10.1093/neuonc/noad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Survivors of pediatric central nervous system (CNS) tumors treated with craniospinal irradiation (CSI) exhibit long-term cognitive difficulties. Goals of this study were to evaluate longitudinal effects of candidate and novel genetic variants on cognitive decline following CSI. METHODS Intelligence quotient (IQ), working memory (WM), and processing speed (PS) were longitudinally collected from patients treated with CSI (n = 241). Genotype-by-time interactions were evaluated using mixed-effects linear regression to identify common variants (minor allele frequency > 1%) associated with cognitive performance change. Novel variants associated with cognitive decline (P < 5 × 10-5) in individuals of European ancestry (n = 163) were considered replicated if they demonstrated consistent genotype-by-time interactions (P < .05) in individuals of non-European ancestries (n = 78) and achieved genome-wide statistical significance (P < 5 × 10-8) in a meta-analysis across ancestry groups. RESULTS Participants were mostly males (65%) diagnosed with embryonal tumors (98%) at a median age of 8.3 years. Overall, 1150 neurocognitive evaluations were obtained (median = 5, range: 2-10 per participant). One of the five loci previously associated with cognitive outcomes in pediatric CNS tumors survivors demonstrated significant time-dependent IQ declines (PPARA rs6008197, P = .004). Two variants associated with IQ in the general population were associated with declines in IQ after Bonferroni correction (rs9348721, P = 1.7 × 10-5; rs31771, P = 7.8 × 10-4). In genome-wide analyses, we identified novel loci associated with accelerated declines in IQ (rs116595313, meta-P = 9.4 × 10-9), WM (rs17774009, meta-P = 4.2 × 10-9), and PS (rs77467524, meta-P = 1.5 × 10-8; rs17630683, meta-P = 2.0 × 10-8; rs73249323, meta-P = 3.1 × 10-8). CONCLUSIONS Inherited genetic variants involved in baseline cognitive functioning and novel susceptibility loci jointly influence the degree of treatment-associated cognitive decline in pediatric CNS tumor survivors.
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Affiliation(s)
- Austin L Brown
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Pagna Sok
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | | | - Philip J Lupo
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Melissa A Richard
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Alanna C Morrison
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Jun J Yang
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Clinton F Stewart
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Mehmet Fatih Okcu
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | | | - Amar Gajjar
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Lisa S Kahalley
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Heather Conklin
- Psychology Department, St. Jude Children’s Research Hospital, Memphis, Tennessee
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Zucchetti G, Gamberini G, Ciappina S, Cagnazzo C, Ricci F, Vallero S, Quarello P, Peretta P, Fagioli F. Neurocognitive and Psychological Outcomes among Children and Adolescents with Brain Tumors: Development of an Observational and Longitudinal Prospective Study Protocol. Behav Sci (Basel) 2023; 13:536. [PMID: 37503983 PMCID: PMC10376337 DOI: 10.3390/bs13070536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/08/2023] [Accepted: 06/24/2023] [Indexed: 07/29/2023] Open
Abstract
Children and adolescents affected by brain tumors are at risk for neuropsychological sequelae that need to be evaluated in order to plan adequate rehabilitation programs, and to support their development and recovery. This work aims to describe an innovative prospective observational study protocol for the early evaluation and monitoring over time of neuropsychological outcomes in this pediatric population. Pediatric patients aged 3-17 with a brain tumor diagnosis will be assessed through the use of a battery of Italian standardized neuropsychological tests, with good psychometric properties and age-appropiate, at three different time points of their clinical course: at diagnosis and before surgery (T0), after surgical removal and before the start of potential adjuvant therapies (T1), and at the one-year follow-up after potential adjuvant therapies (T2). This study will allow clinicians to support the neuropsychological development of these children by promoting appropriate and timely rehabilitation and educational programs from the early phases of their clinical course.
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Affiliation(s)
- Giulia Zucchetti
- Pediatric Oncology and Hematology Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (G.Z.); (C.C.); (S.V.); (P.Q.); (F.F.)
| | - Giorgia Gamberini
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, Regina Margherita Children’s Hospital, University of Turin, 10126 Turin, Italy; (G.G.); (F.R.)
| | - Sabrina Ciappina
- Pediatric Oncology and Hematology Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (G.Z.); (C.C.); (S.V.); (P.Q.); (F.F.)
| | - Celeste Cagnazzo
- Pediatric Oncology and Hematology Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (G.Z.); (C.C.); (S.V.); (P.Q.); (F.F.)
| | - Federica Ricci
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, Regina Margherita Children’s Hospital, University of Turin, 10126 Turin, Italy; (G.G.); (F.R.)
| | - Stefano Vallero
- Pediatric Oncology and Hematology Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (G.Z.); (C.C.); (S.V.); (P.Q.); (F.F.)
| | - Paola Quarello
- Pediatric Oncology and Hematology Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (G.Z.); (C.C.); (S.V.); (P.Q.); (F.F.)
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
| | - Paola Peretta
- High-Intensity Surgery Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy;
| | - Franca Fagioli
- Pediatric Oncology and Hematology Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (G.Z.); (C.C.); (S.V.); (P.Q.); (F.F.)
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
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11
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Ramjan S, Levitch C, Sands S, Kim SY, Barnett M, Bledsoe J, Holland AA. Executive and social functioning in pediatric posterior fossa tumor survivors and healthy controls. Neurooncol Pract 2023; 10:152-161. [PMID: 36970175 PMCID: PMC10037940 DOI: 10.1093/nop/npac090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Executive and social functioning difficulty is well established in pediatric brain tumor survivors. Few studies have compared posterior fossa (PF) tumor survivors in comparison to their peers. The relationship between attention, processing speed, working memory, fatigue, and executive and social functioning was investigated to better understand the factors that impact executive and social functioning in PF tumor populations. Methods Sixteen medulloblastomas, 9 low-grade astrocytomas (LGAs), and 17 healthy controls recruited from 4 sites completed measures of working memory and processing speed, and self-reported fatigue. One parent completed questionnaires on executive and social functioning. Results There were no significant differences among all 3 groups on parent-reported executive and social functioning; of note, parents of LGA survivors expressed greater concerns regarding behavioral and cognitive regulation than did parents of medulloblastoma survivors and healthy controls. Parent-reported attention was related to parent-reported emotion, behavior, and cognitive regulation. Worse self-reported fatigue was associated with greater emotional dysregulation for the 2 PF tumor groups. Conclusions Parents of PF tumor survivors described their children as performing similarly to their peers in most facets of executive and social functioning. While LGA survivors are traditionally thought to have more favorable outcomes, our finding of parent-reported executive functioning concerns to be worse for this group highlights the importance of long-term follow-up for all PF tumor survivors. Additionally, significant effects of attention on aspects of executive functioning in PF tumor survivors may inform current clinical practice and the future development of more effective interventions.
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Affiliation(s)
- Sameera Ramjan
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Cara Levitch
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Stephen Sands
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Soo Young Kim
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Marie Barnett
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jesse Bledsoe
- Department of Psychiatry and Behavioral Sciences, Seattle Children's Hospital, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Alice Ann Holland
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Psychiatry, Children's Medical Center Dallas, Dallas, Texas, USA
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12
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Brown KL, Fairclough D, Noll RB, Barrera M, Kupst MJ, Gartstein MA, Egan AM, Bates CR, Gerhardt CA, Vannatta K. Emotional Well-Being of Pediatric Brain Tumor Survivors and Comparison Peers: Perspectives From Children and Their Parents. J Pediatr Psychol 2023; 48:166-175. [PMID: 36190446 PMCID: PMC9941833 DOI: 10.1093/jpepsy/jsac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 08/13/2022] [Accepted: 09/18/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine the emotional well-being of pediatric brain tumor survivors (PBTS) from the perspective of children's self-reports and parents' reports relative to matched comparison peers (COMP) and their parents. It was hypothesized that PBTS would self-report more depression symptoms, loneliness, and lower self-concept than COMP. We also hypothesized that mothers and fathers of PBTS would report more internalizing symptoms and lower total competence for their children. Age and sex effects were examined in exploratory analyses. METHODS Families of 187 PBTS and 186 COMP participated across 5 sites. Eligible children in the PBTS group were 8-15 years of age and 1-5 years post-treatment for a primary intracranial tumor without progressive disease. COMP were classmates matched for sex, race, and age. RESULTS PBTS self-reported lower scholastic, athletic, and social competence, but not more depression, loneliness, or lower global self-worth than COMP. Parents of PBTS reported more internalizing symptoms and lower total competence than parents of COMP. With few exceptions, group differences did not vary as a function of child age and sex. CONCLUSION PBTS reported diminished self-concept in scholastic, athletic, and social domains, while their parents reported broader challenges with internalizing symptoms and total competence. Discrepancies between self-report and parent report require further study to inform targeted interventions for PBTS. Screening survivors for emotional challenges in follow-up clinic or in school setting may help with the allocation of psychosocial support and services for PBTS and their families.
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Affiliation(s)
- Kara L Brown
- Department of Psychology, Washington State University, USA
| | - Diane Fairclough
- Department of Biostatistics and Informatics, Colorado School of Public Health, USA
| | - Robert B Noll
- Department of Pediatrics, University of Pittsburgh Medical Center, USA
| | - Maru Barrera
- Psychology Department, The Hospital for Sick Children, USA
| | - Mary Jo Kupst
- Department of Pediatrics, Medical College of Wisconsin, USA
| | | | - Anna M Egan
- Division of Developmental and Behavioral Sciences, Children's Mercy Kansas City, USA
- University of Missouri Kansas City School of Medicine, USA
| | - Carolyn R Bates
- Department of Pediatrics, The University of Kansas Medical Center, USA
| | - Cynthia A Gerhardt
- Center for Biobehavioral Health, Nationwide Children’s Hospital, USA
- Department of Pediatrics, The Ohio State University, USA
| | - Kathryn Vannatta
- Center for Biobehavioral Health, Nationwide Children’s Hospital, USA
- Department of Pediatrics, The Ohio State University, USA
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13
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Lönnerblad M, Åberg M, Blomgren K, Berglund E. Post-Compulsory Education in Teenagers and Young Adults Treated for Brain Tumors in Childhood: A Swedish Nationwide Registry-Based Study. Cancers (Basel) 2022; 15:cancers15010255. [PMID: 36612254 PMCID: PMC9818516 DOI: 10.3390/cancers15010255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/15/2022] [Accepted: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
The risk of late complications after a brain tumor in childhood is high. Both the tumor itself and the treatments give rise to sequelae that affect daily life activities. In this registry study, we explored post-compulsory education, i.e., further education following the nine compulsory years in school, in 452 cases born 1988-1996 and diagnosed with a brain tumor before their fifteenth birthday. They were compared with 2188 individual controls who were not treated for cancer. Significantly fewer teenagers and young adults treated for brain tumors in childhood attended high school or university compared with controls, especially individuals treated for embryonal tumors or optic pathway gliomas. A significantly larger proportion of subjects treated for embryonal tumors and craniopharyngiomas attended folk high schools, a type of post-compulsory school with a more accessible learning environment. For both cases and controls, we observed a positive correlation between parental education levels and attendance in high school and university. In our previous studies we have shown that children treated for brain tumors, as a group, tend to perform worse during their last year of compulsory school compared with their peers, and the current study confirms that these differences remain over time.
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Affiliation(s)
- Malin Lönnerblad
- Department of Women’s and Children’s Health, Uppsala University, Akademiska Sjukhuset, 75185 Uppsala, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 64 Stockholm, Sweden
- Department of Special Education, Stockholm University, 10691 Stockholm, Sweden
- Correspondence: ; Tel.:+46-734697279
| | - Maria Åberg
- School of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, 40530 Gothenburg, Sweden
- Regionhälsan, Region Västra Götaland, 40583 Gothenburg, Sweden
| | - Klas Blomgren
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 64 Stockholm, Sweden
- Pediatric Oncology, Karolinska University Hospital, 17164 Stockholm, Sweden
| | - Eva Berglund
- Department of Special Education, Stockholm University, 10691 Stockholm, Sweden
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Gandy K, Chambers T, Raghubar KP, Fatih Okcu M, Chintagumpala M, Taylor O, Mahajan A, Kahalley LS, Chan W, Grosshans DR, Brown AL, Douglas Ris M. A Prospective Evaluation of Fatigue in Pediatric Brain Tumor Patients Treated With Radiation Therapy. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:358-365. [PMID: 36285825 DOI: 10.1177/275275302110560011068754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background: Fatigue is a well-established consequence of cranial radiotherapy in survivors of pediatric brain tumor, but less is known about acute fatigue during radiotherapy treatment. This study aimed to longitudinally evaluate fatigue in newly diagnosed pediatric patients with brain tumors during treatment. Methods: Primary caregivers of pediatric patients with brain tumors completed the proxy-reported Parent Fatigue Scale assessments prior to radiotherapy and weekly during radiotherapy treatment. The association between clinical factors and fatigue at each assessment was evaluated with multiple linear regressions. A comparison of fatigue between radiation modalities was also analyzed. Results: A total of 33 caregivers completed pre-radiation fatigue assessments, with 29 reporting fatigue during radiotherapy. Patients were aged 3 to 16 years (M = 8.32) at diagnosis and diagnosed with medulloblastoma (n = 23), primitive neuroectodermal tumor (n = 2), ependymoma (n = 1), germ cell tumor (n = 1), pineoblastoma (n = 1), atypical teratoid rhabdoid (n = 1), and other unspecific tumors (n = 3). Moderate-to-severe fatigue was reported for the majority of patients (31/33; 94%) during treatment. Craniospinal irradiation dose was the only significant predictor of fatigue (p < .05), but this association was restricted to the first week of therapy and was attenuated by therapy completion. Discussion: Although fatigue is often considered a long-term consequence of cranial radiotherapy, this pilot study demonstrates that moderate-to-severe fatigue is pervasive prior to radiotherapy and persists throughout treatment in pediatric patients with brain tumors, regardless of radiation modality or clinical factors. Additional research is warranted to establish a link between acute and long-term fatigue and develop interventions to mitigate this adverse outcome.
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Affiliation(s)
- Kellen Gandy
- Department of Pediatrics, 3989Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Tiffany Chambers
- Department of Pediatrics, 3989Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Kimberly P Raghubar
- Department of Pediatrics, 3989Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Mehmet Fatih Okcu
- Department of Pediatrics, 3989Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Murali Chintagumpala
- Department of Pediatrics, 3989Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Olga Taylor
- Department of Pediatrics, 3989Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Anita Mahajan
- Department of Radiation Oncology, 4002The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lisa S Kahalley
- Department of Pediatrics, 3989Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Wenyaw Chan
- Department of Biostatistics, School of Public Health, 12340University of Texas Health Science Center at Houston, Houston, TX, USA
| | - David R Grosshans
- Department of Radiation Oncology, 4002The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Austin L Brown
- Department of Pediatrics, 3989Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Martin Douglas Ris
- Department of Pediatrics, 3989Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
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15
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Levesque A, Caru M, Duval M, Laverdière C, Marjerrison S, Sultan S. Cancer-related fatigue in childhood cancer survivors: A systematic scoping review on contributors of fatigue and how they are targeted by non-pharmacological interventions. Crit Rev Oncol Hematol 2022; 179:103804. [PMID: 36087854 DOI: 10.1016/j.critrevonc.2022.103804] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES We aimed to identify contributors to cancer-related fatigue (CRF), explore non-pharmacological interventions addressing CRF, and highlight which contributors were targeted by these interventions in childhood cancer survivors. METHODS We performed a search in various databases and used the PRISMA-ScR checklist. Findings were synthesized in various different tables and figures in accordance with our objectives. RESULTS We included 49 articles in this systematic scoping review. We identified 59 significant contributors. Depression and physical activity level were some of the most studied significant contributors. Ten interventional studies were identified (e.g., yoga, physical activity intervention) that addressed 6 contributors (e.g., physical activity level). DISCUSSION This review is the first to describe and relate contributors and non-pharmacological interventions targeting CRF in childhood cancer survivors. Important clinical implications could be derived from the variety of factors explaining CRF and how it is currently addressed.
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Affiliation(s)
- Ariane Levesque
- Department of Psychology, Université de Montreal, Montreal, Canada; Research Center, Sainte-Justine University Health Center, Montreal, Canada.
| | - Maxime Caru
- Department of Pediatric Hematology and Oncology, and Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Michel Duval
- Research Center, Sainte-Justine University Health Center, Montreal, Canada; Charles-Bruneau Cancer Care Center, Sainte-Justine University Health Center, Montreal, Canada; Department of Pediatrics, Université de Montreal, Montreal, Canada
| | - Caroline Laverdière
- Research Center, Sainte-Justine University Health Center, Montreal, Canada; Charles-Bruneau Cancer Care Center, Sainte-Justine University Health Center, Montreal, Canada; Department of Pediatrics, Université de Montreal, Montreal, Canada
| | - Stacey Marjerrison
- Department of Pediatrics, McMaster University Children's Hospital, Hamilton, Ontario, Canada
| | - Serge Sultan
- Department of Psychology, Université de Montreal, Montreal, Canada; Research Center, Sainte-Justine University Health Center, Montreal, Canada; Charles-Bruneau Cancer Care Center, Sainte-Justine University Health Center, Montreal, Canada; Department of Pediatrics, Université de Montreal, Montreal, Canada
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16
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The Current State of Radiotherapy for Pediatric Brain Tumors: An Overview of Post-Radiotherapy Neurocognitive Decline and Outcomes. J Pers Med 2022; 12:jpm12071050. [PMID: 35887547 PMCID: PMC9315742 DOI: 10.3390/jpm12071050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
Tumors of the central nervous system are the most common solid malignancies diagnosed in children. While common, they are also found to have some of the lowest survival rates of all malignancies. Treatment of childhood brain tumors often consists of operative gross total resection with adjuvant chemotherapy or radiotherapy. The current body of literature is largely inconclusive regarding the overall benefit of adjuvant chemo- or radiotherapy. However, it is known that both are associated with conditions that lower the quality of life in children who undergo those treatments. Chemotherapy is often associated with nausea, emesis, significant fatigue, immunosuppression, and alopecia. While radiotherapy can be effective for achieving local control, it is associated with late effects such as endocrine dysfunction, secondary malignancy, and neurocognitive decline. Advancements in radiotherapy grant both an increase in lifetime survival and an increased lifetime for survivors to contend with these late effects. In this review, the authors examined all the published literature, analyzing the results of clinical trials, case series, and technical notes on patients undergoing radiotherapy for the treatment of tumors of the central nervous system with a focus on neurocognitive decline and survival outcomes.
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17
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Stubberud J, Hypher R, Brandt AE, Finnanger TG, Skovlund E, Andersson S, Risnes K, Rø TB. Predictors of Functional School Outcome in Children With Pediatric Acquired Brain Injury. Front Neurol 2022; 13:872469. [PMID: 35493829 PMCID: PMC9047759 DOI: 10.3389/fneur.2022.872469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Among the variety of domains that may be impacted after pediatric acquired brain injury (pABI) are functional school outcomes. The purpose of this study was to identify demographic, medical, and psychological factors associated with impairments in functional school outcomes, defined as school absence, need of educational and psychological services, quality of life (QoL) in the school setting, and academic performance in children with pABI, with a specific emphasis on the significance of fatigue. Materials and Method We used baseline data from a randomized controlled trial. The sample consisted of seventy-six children aged 10 to 17 (M = 13 yrs) with pABI in the chronic phase (>1 year). All completed assessments of school-related QoL, academic performance, global functioning, fatigue, IQ, behavioral problems, and executive function. Results Fatigue, IQ, global functioning, behavioral problems, and sex emerged as potential predictors for functional school outcomes. Of note, overall fatigue emerged as the strongest potential predictor for parent-reported QoL in school (β = 0.548; p < 0.001) and self-reported QoL in school (β = 0.532; p < 0.001). Conclusions Following pABI, specific psychological, medical, and demographic factors are associated with functional school outcomes. Neither of the injury-related variables age at insult and time since insult were associated with functional school outcomes. Overall, our findings may suggest that a reintroduction to school with personalized accommodations tailored to the child's specific function and symptoms, such as fatigue, is recommended.
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Affiliation(s)
- Jan Stubberud
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
- *Correspondence: Jan Stubberud
| | - Ruth Hypher
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | - Anne E. Brandt
- Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torun G. Finnanger
- Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Eva Skovlund
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stein Andersson
- Department of Psychology, University of Oslo, Oslo, Norway
- Psychosomatic and CL Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kari Risnes
- Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torstein B. Rø
- Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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18
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Bonanno M, Bourque CJ, Aramideh J, Cloutier N, Dumont É, Gomez-Tyo M, Julien-Lacoste A, Košir U, Provost C, Laverdière C, Sultan S. Articulating viewpoints to better define and respond to the needs of adolescents and young adult survivors of pediatric brain tumors. J Psychosoc Oncol 2021; 40:347-365. [PMID: 34859737 DOI: 10.1080/07347332.2021.2004291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE Adolescents and young adult survivors of pediatric brain tumors (AYA-PBTS) often experience difficulties with social skills, pursuit of studies and employment. This study explored pediatric long-term survivors' perspective on their post-treatment needs and ways to improve resources and interventions. METHODS We used an original method of three sequential focus group interviews by adding the perspectives of survivors (15-22 years), parents and health professionals (total N = 22). Participants were recruited using purposive sampling from the long-term follow-up clinic at a Canadian tertiary hospital. We used computer-assisted analysis to draw themes from each group and compare thematic content across groups. RESULTS Categorization of participants' responses resulted in three domains: personal life, education and work. Participants mentioned the improvement of communication tools to facilitate access to timely information, the organization of counseling to improve employment integration, and tailoring interventions to optimize the return to daily activities in aftercare. Subsequent inductive analysis revealed three overarching trends among groups: multipurpose social networking, AYA-PBTS-specific information websites and transition tools and procedures. CONCLUSION AND IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS This study identified solutions for AYA-PBTS' specific needs in aftercare. This population needs up-to-date post-treatment information and refined outreach procedures. Future research should define and prioritize these suggested solutions.
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Affiliation(s)
- Marco Bonanno
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, Canada.,Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, Canada
| | - Claude Julie Bourque
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, Canada.,Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Jennifer Aramideh
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, Canada.,Department of Psychology, Université de Montréal, Montreal, Canada
| | - Nancy Cloutier
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, Canada
| | - Émilie Dumont
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, Canada
| | | | - Ariane Julien-Lacoste
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, Canada
| | - Urška Košir
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Carole Provost
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, Canada
| | - Caroline Laverdière
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, Canada.,Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Serge Sultan
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, Canada.,Department of Psychology, Université de Montréal, Montreal, Canada
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19
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Difficulties encountered by physicians and mental health professionals in evaluating and caring for affective and behavioral problems in pediatric brain tumor survivors. Support Care Cancer 2021; 29:6771-6780. [PMID: 33990882 DOI: 10.1007/s00520-021-06250-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Pediatric brain tumor survivors (PBTS) present a high risk for emotional and behavioral disorders. When addressing these difficulties, differences in study designs; variety of and disagreement about diagnoses; and intricate links of emotional, behavioral, and cognitive issues may complicate the interpretation of studies and probably also the work of clinicians. We aimed to survey the difficulties perceived by physicians and mental health professionals in their practice and their interest in developing a new evaluative tool. METHODOLOGY We surveyed 29 health professionals involved in the follow-up of this population. They completed questionnaires about their clinical practice (difficulties, needs, activities) and indicated diagnosis hypotheses and treatment plans on a clinical case developed for this study. RESULTS Emotional and behavioral disorders were reported as difficult to assess for 93% of participants. The overlap of symptoms (90%) and the lack of an adapted diagnostic framework (90%) were the main reasons mentioned. Respectively 93%, 90%, and 65% of participants would at least "often" make referrals to psychological (93%), neuropsychological (90%), and psychiatric (65%) assessments and care. Family and group therapy were less common as was drug management. All participants were in favor of creating a tool to help with diagnosis and treatment. When responding to a clinical case, the heterogeneity of participants' responses highlighted their issues in diagnosing and managing these patients. CONCLUSION This survey exemplifies the difficulties of health professionals related to the evaluation and management of affective and behavioral disorders experienced by PBTS. It underlines the need to help professionals by initiating systematic assessment strategies with this vulnerable population.
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20
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Recommendations for the surveillance of cancer-related fatigue in childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. J Cancer Surviv 2020; 14:923-938. [PMID: 32839902 PMCID: PMC7572340 DOI: 10.1007/s11764-020-00904-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/03/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Cancer-related fatigue (CRF) negatively affects the lives of childhood, adolescent, and young adult (CAYA) cancer survivors. We aimed to provide an evidence-based clinical practice guideline (CPG) with internationally harmonized CRF surveillance recommendations for CAYA cancer survivors diagnosed < 30 years. METHODS This CPG was developed by a multidisciplinary panel under the umbrella of the International Late Effects of Childhood Cancer Guideline Harmonization Group. After evaluating concordances and discordances of four existing CPGs, we performed systematic literature searches. We screened articles for eligibility, assessed quality, extracted, and summarized the data from included articles. We formulated recommendations based on the evidence and clinical judgment. RESULTS Of 3647 articles identified, 70 articles from 14 countries were included. The prevalence of CRF in CAYA cancer survivors ranged from 10-85%. We recommend that healthcare providers are aware of the risk of CRF, implement regular screening with validated measures, and recommend effective interventions to fatigued survivors. CONCLUSIONS A considerable proportion of CAYA cancer survivors suffers from CRF even years after the end of treatment. IMPLICATIONS FOR CANCER SURVIVORS We recommend that healthcare providers adopt regular screening to detect and treat CRF early and positively influence survivors' health and quality of life.
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21
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van Deuren S, Boonstra A, van Dulmen‐den Broeder E, Blijlevens N, Knoop H, Loonen J. Severe fatigue after treatment for childhood cancer. Cochrane Database Syst Rev 2020; 3:CD012681. [PMID: 32124971 PMCID: PMC7059965 DOI: 10.1002/14651858.cd012681.pub2] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Treatment strategies for childhood cancer are improving, resulting in higher survival rates. However, the consequences of childhood cancer do not end with the successful completion of cancer treatment. Most patients will develop late effects after cessation of treatment. Severe fatigue is seen as a common and debilitating late effect in cancer survivors. Although most research on fatigue has been performed in patients after adult-onset cancer, our review focuses on fatigue after childhood cancer. OBJECTIVES To estimate the prevalence of severe fatigue after treatment for childhood cancer. Secondary objectives are to describe the course of severe fatigue following cancer treatment and to examine risk factors for fatigue, or factors associated with it. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (the Cochrane Library 2019; issue 8 March 2019), MEDLINE/PubMed (from 1945 to 8 March 2019), Embase/Ovid (from 1947 to 8 March 2019), reference lists of included articles and several conference proceedings from 2011 to 2018. SELECTION CRITERIA Observational studies, randomised controlled trials and controlled clinical trials reporting on fatigue in participants after treatment for childhood cancer. Case series and case reports were not eligible for inclusion. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risks of bias. If the publication did not present the prevalence of severe fatigue, we contacted study authors for additional information. MAIN RESULTS We included 30 studies (18,682 participants in total). Eighteen studies contributed to the main objective and 22 studies contributed to the secondary objectives. We found substantial differences between studies in cancer diagnosis, cancer treatment, age of participants, questionnaires used to assess fatigue, and sample size. All included studies scored at least one 'Risk of bias' item as unclear or high risk. We identified both clinical and statistical heterogeneity and therefore could not pool results, so we present them descriptively. Eighteen studies (describing 14,573 survivors) reported the prevalence of severe fatigue, which ranged from 0% to 61.7%. In a subgroup of three studies including children aged up to 18 years at fatigue assessment (268 survivors), prevalence rates ranged from 6.7% to 12.5%. In comparison, in a subgroup of 12 studies including participants aged 16 and over (13,952 survivors), prevalence rates ranged from 4.4% to 61.7%. The prevalence of severe fatigue in a subgroup of survivors of haematological cancer was presented in seven studies and ranged from 1.8% to 35.9% (1907 survivors). Prevalence of severe fatigue in brain cancer survivors was presented in two studies (252 survivors) and was 14.6% and 21.1% respectively. One study presented a prevalence for bone cancer survivors of 0.0% (17 survivors). Four studies provided prevalence rates of severe fatigue in control groups of siblings or population-based controls, which ranged from 3.1% to 10.3%. In these four studies, survivors were more often fatigued than controls, but this difference was statistically significant in only two studies. Studies assessing risk and associated factors for fatigue were heterogeneous, and definitions of the factors under study were often inconsistent, with results therefore presented descriptively. They found that depression might be associated with fatigue. In contrast, age at diagnosis and education level did not seem to be associated with fatigue. We were unable to calculate any overall risk estimate for any of the reported risks and associated factors, because we could not conduct meta-analysis. One study provided information about the course of fatigue over time, and found that over the course of 2.7 years, 32 of the 102 participants (31.4%) reported persistent severe fatigue. AUTHORS' CONCLUSIONS It is unclear how many childhood cancer survivors suffer from severe fatigue. This review encountered several difficulties. We found statistical and clinical heterogeneity and great variation in the reporting of possible risk and associated factors. The evidence in this review is therefore weak, and the exact prevalence of severe fatigue after treatment for childhood cancer remains to be determined. This is also the case for the course of severe fatigue following treatment and the strength of the relationship between fatigue and associated and risk factors. Despite these limitations, our review does provide a comprehensive overview of the existing literature about severe fatigue after treatment for childhood cancer.
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Affiliation(s)
- Sylvia van Deuren
- Radboud University Medical CenterDepartment of HematologyGeert Grooteplein Zuid 8NijmegenNetherlands6500 HB
| | - Amilie Boonstra
- Radboud University Medical CenterDepartment of HematologyGeert Grooteplein Zuid 8NijmegenNetherlands6500 HB
| | - Eline van Dulmen‐den Broeder
- Amsterdam UMC, Vrije Universiteit AmsterdamDepartment of Pediatrics, Division of Oncology/HematologyPO Box 7057AmsterdamNetherlands1007 MB
| | - Nicole Blijlevens
- Radboud University Medical CenterDepartment of HematologyGeert Grooteplein Zuid 8NijmegenNetherlands6500 HB
| | - Hans Knoop
- Amsterdam UMC, University of AmsterdamDepartment of Medical PsychologyMeibergdreef 9AmsterdamNetherlands1105 AZ
| | - Jacqueline Loonen
- Radboud University Medical CenterDepartment of HematologyGeert Grooteplein Zuid 8NijmegenNetherlands6500 HB
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22
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Roche J, Câmara-Costa H, Roulin JL, Chevignard M, Frappaz D, Guichardet K, Benkhaled O, Kerrouche B, Prodhomme J, Kieffer-Renaux V, Le Gall D, Fournet N, Roy A. Assessment of everyday executive functioning using the BRIEF in children and adolescents treated for brain tumor. Brain Inj 2020; 34:583-590. [DOI: 10.1080/02699052.2020.1725982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Jeanne Roche
- Laboratory of Psychology Pays de la Loire, EA4638, UBL, Angers University, Angers, France
- SMAEC, Resource Centre for Children, Adolescents, Young Adults with Acquired Neurological Injury, Miribel, France
| | - Hugo Câmara-Costa
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- Laboratoire d’Imagerie Biomédicale, LIB, Sorbonne Université, Paris, France
| | - Jean-Luc Roulin
- University Grenoble Alpes, University Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
| | - Mathilde Chevignard
- Laboratoire d’Imagerie Biomédicale, LIB, Sorbonne Université, Paris, France
- Rehabilitation Department for children with acquired neurological injury, and Outreach team for children and adolescents with acquired brain injury, Saint Maurice Hospitals, Saint Maurice, France
- GRC 24 HaMCRe, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France
| | - Didier Frappaz
- Institut d’Hématologie et d’Oncologie Pédiatrique, Lyon, France
| | - Karine Guichardet
- Medical Clinic of Paediatrics, HCE, CHU de Grenoble Alpes, Grenoble, France
| | - Ouarda Benkhaled
- Rehabilitation Department for children with acquired neurological injury, and Outreach team for children and adolescents with acquired brain injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Bernadette Kerrouche
- Rehabilitation Department for children with acquired neurological injury, and Outreach team for children and adolescents with acquired brain injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Julie Prodhomme
- Rehabilitation Department for children with acquired neurological injury, and Outreach team for children and adolescents with acquired brain injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Virginie Kieffer-Renaux
- Rehabilitation Department for children with acquired neurological injury, and Outreach team for children and adolescents with acquired brain injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Didier Le Gall
- Laboratory of Psychology Pays de la Loire, EA4638, UBL, Angers University, Angers, France
- Département de neurologie, CHU d’Angers, Université Bretagne Loire, France
| | - Nathalie Fournet
- University Grenoble Alpes, University Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
| | - Arnaud Roy
- Laboratory of Psychology Pays de la Loire, EA4638, UBL, Angers University, Angers, France
- Centre Référent des Troubles d’Apprentissage, Centre de Compétence Nantais de Neurofibromatose, Hôpital Femme-Enfant-Adolescent, CHU de Nantes, Nantes, France
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23
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Lönnerblad M, Van't Hooft I, Blomgren K, Berglund E. A nationwide, population-based study of school grades, delayed graduation, and qualification for school years 10-12, in children with brain tumors in Sweden. Pediatr Blood Cancer 2020; 67:e28014. [PMID: 31595683 DOI: 10.1002/pbc.28014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 08/28/2019] [Accepted: 09/06/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND As many as 95.7% of children diagnosed with a brain tumor will experience persistent late effects as adults. These include difficulties with general executive functions, lower IQ, and mental fatigue, which may negatively affect school performance. METHODS Through the Swedish Childhood Cancer Registry, we identified 475 children born between 1988 and 1996, diagnosed with a brain tumor before their 15th birthday. School grades in "Swedish," "mathematics," and "English," if their graduation was delayed, and qualification for school years 10-12 were compared with 2197 matched controls. Furthermore, we checked for interaction effects between sex and age at diagnosis, and possible effects of tumor grade (high or low) as well as parents' education. RESULTS Children treated for a brain tumor performed worse in the subjects compared to controls and also had delayed graduation to a greater extent. Fewer children treated for a brain tumor than controls qualified for school years 10-12. Children treated at a young age, especially females, and children whose parents have low education seem to be at particular risk. Unexpectedly, there were no differences in outcomes between survivors with high- and low-grade tumors. CONCLUSIONS It is important that schools provide regular pedagogical assessment and individualized support to meet the different needs of children treated for a brain tumor. Children treated for low-grade tumors do not perform better than children treated for high-grade tumors, despite the lighter treatment, and hence require the same attention and support.
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Affiliation(s)
- Malin Lönnerblad
- Department of Special Education, Stockholm University, Stockholm, Sweden.,Neuropediatric Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Ingrid Van't Hooft
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Klas Blomgren
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Pediatric Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Berglund
- Department of Special Education, Stockholm University, Stockholm, Sweden
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24
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Vanclooster S, Van Hoeck K, Peremans L, Bilsen J, Van Der Werff Ten Bosch J, Laureys G, Paquier P, Jansen A. Reintegration into school of childhood brain tumor survivors: a qualitative study using the International Classification of Functioning, Disability and Health – Children and Youth framework. Disabil Rehabil 2020; 43:2610-2620. [DOI: 10.1080/09638288.2019.1708484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
| | | | - Lieve Peremans
- Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
| | - Johan Bilsen
- Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Geneviève Laureys
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Philippe Paquier
- Center for Linguistics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Anna Jansen
- Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
- Pediatric Neurology Unit, UZ Brussel, Brussels, Belgium
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25
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Social attainment in survivors of pediatric central nervous system tumors: a systematic review and meta-analysis from the Children's Oncology Group. J Cancer Surviv 2019; 13:921-931. [PMID: 31625086 DOI: 10.1007/s11764-019-00808-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 09/06/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Improved therapies for pediatric central nervous system (CNS) tumors have increased survival rates; however, many survivors experience significant long-term functional limitations. Survivors of pediatric CNS tumors can experience deficits in social attainment. The aim of this review was to systematically amalgamate findings pertaining to social attainment (i.e., educational attainment, marriage, employment outcomes) in survivors of pediatric CNS tumors. METHODS PubMed (web-based), PsycINFO (EBSCO), EMBASE (Ovid), and Web of Science (Thomson Reuters) were used to identify articles published between January 2011 and September 2018. Eligible studies reported outcomes for survivors of pediatric CNS tumors diagnosed before age 21 years and > 5 years from diagnosis and/or > 2 years off therapy. All data were independently abstracted by two reviewers. Random-effects meta-analyses were performed using Review Manager 5.0. RESULTS The search yielded 7021 unique publications. Forty-six were included in the current review. Meta-analyses revealed survivors of CNS tumors were significantly more likely to have completed compulsory education only (OR = 1.87, 95% CI = 1.66, 2.12, p < 0.00001), less likely to be married (OR = 4.70, 95% CI = 3.89, 5.68, p < 0.00001), and more likely to be unemployed (OR = 2.84, 95% CI = 2.62, 3.08, p < 0.00001) compared to non-cancer controls. Cranial radiation therapy, neurocognitive deficits, and younger age at diagnosis were associated with poorer outcomes. Hearing loss and bilateral blindness were also related to poorer outcomes. Sex did not impact social attainment outcomes. CONCLUSIONS Survivors of pediatric CNS tumors are at elevated risk for poor attainment of key adult social outcomes. IMPLICATIONS FOR CANCER SURVIVORS There is a critical need to develop interventions to support survivors in becoming independent and productive adults.
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26
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Puhr A, Ruud E, Anderson V, Due-Tønnessen BJ, Skarbø AB, Finset A, Andersson S. Social attainment in physically well-functioning long-term survivors of pediatric brain tumour; the role of executive dysfunction, fatigue, and psychological and emotional symptoms. Neuropsychol Rehabil 2019; 31:129-153. [PMID: 31603026 DOI: 10.1080/09602011.2019.1677480] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this cross-sectional study was to investigate long-term social attainment in physically well-functioning adult survivors of pediatric brain tumour (PBT) and identify demographic, medical, and psychological factors related to poor social outcomes, with a special focus on the significance of executive dysfunction. One hundred and fourteen PBT survivors and a healthy control group provided personal data on social outcomes, i.e., education, work, and government benefits, and completed questionnaires on executive function (EF), psychological and emotional difficulties, and fatigue. A significantly higher number of survivors compared to healthy controls reported having received educational adjustments and substantial government benefits, and significantly more survivors than controls were currently not engaged in regular employment/training. PBT survivors and healthy controls did not differ on educational level or living situation. The factors most strongly associated with poor social outcomes were self-reported executive dysfunction, difficulties with adaptive functioning, and fatigue. The findings show that physically well-functioning PBT survivors are at risk of poorer social outcomes and financial dependence in adulthood compared to their healthy peers, and underline the importance of investigating EF in short- and long-term follow-ups. Future rehabilitation efforts should focus more on compensatory strategies for executive dysfunction and improving EF skills.
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Affiliation(s)
- Anita Puhr
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.,Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Ellen Ruud
- Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Vicki Anderson
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia
| | | | - Anne-Britt Skarbø
- Department of Pediatric Neurology, Oslo University Hospital, Oslo, Norway
| | | | - Stein Andersson
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
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27
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Vanclooster S, Bilsen J, Peremans L, Van Der Werff Ten Bosch J, Laureys G, Paquier P, Jansen A. Reintegration Into School After Treatment for a Brain Tumor: The Child's Perspective. Glob Pediatr Health 2019; 6:2333794X19860659. [PMID: 31321257 PMCID: PMC6610440 DOI: 10.1177/2333794x19860659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 05/02/2019] [Accepted: 06/05/2019] [Indexed: 01/18/2023] Open
Abstract
This multiple case study investigated perspectives of childhood brain tumor
survivors on reintegration into school over a 2-year period. Semistructured
interviews were conducted with 5 children at 3 times to obtain an extensive view
of their overall school experience. Thematic analysis of data resulted in 4
themes: “school life and participation,” “peer relations and friendships,”
“performance and difficulties,” and “support and follow-up.” Childhood brain
tumor survivors consider school attendance as part of a normal disease-free
life. Social contact and friendships represent their main motivating factors for
returning to school. Attitudes and feelings regarding performance, difficulties,
and support vary among survivors and change over time. In conclusion, continuity
in learning and social contact established before the return facilitate the
reintegration process. A comprehensive assessment of their academic and
psychosocial functioning should be organized on reentry. Systematic follow-up by
parents, school staff, and health professionals throughout the child’s school
career is required.
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Affiliation(s)
| | | | - Lieve Peremans
- Vrije Universiteit Brussel, Brussels, Belgium.,University of Antwerp, Antwerp, Belgium
| | | | | | - Philippe Paquier
- Vrije Universiteit Brussel, Brussels, Belgium.,Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Anna Jansen
- Vrije Universiteit Brussel, Brussels, Belgium.,UZ Brussel, Brussels, Belgium
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Puhr A, Ruud E, Anderson V, Due-Tønnesen BJ, Skarbø AB, Finset A, Andersson S. Self-Reported Executive Dysfunction, Fatigue, and Psychological and Emotional Symptoms in Physically Well-Functioning Long-Term Survivors of Pediatric Brain Tumor. Dev Neuropsychol 2018; 44:88-103. [DOI: 10.1080/87565641.2018.1540007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Anita Puhr
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Department of Pediatric Neurology, Oslo University Hospital, Oslo, Norway
| | - Ellen Ruud
- Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Vicki Anderson
- Murdoch Children’s Research Institute, The Royal Children’s Hospital, Melbourne, Australia
| | | | - Anne-Britt Skarbø
- Department of Pediatric Neurology, Oslo University Hospital, Oslo, Norway
| | | | - Stein Andersson
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
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29
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Stavinoha PL, Askins MA, Powell SK, Pillay Smiley N, Robert RS. Neurocognitive and Psychosocial Outcomes in Pediatric Brain Tumor Survivors. Bioengineering (Basel) 2018; 5:E73. [PMID: 30208602 PMCID: PMC6164803 DOI: 10.3390/bioengineering5030073] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/06/2018] [Accepted: 09/08/2018] [Indexed: 01/15/2023] Open
Abstract
The late neurocognitive and psychosocial effects of treatment for pediatric brain tumor (PBT) represent important areas of clinical focus and ongoing research. Neurocognitive sequelae and associated problems with learning and socioemotional development negatively impact PBT survivors' overall health-related quality of life, educational attainment and employment rates. Multiple factors including tumor features and associated complications, treatment methods, individual protective and vulnerability factors and accessibility of environmental supports contribute to the neurocognitive and psychosocial outcomes in PBT survivors. Declines in overall measured intelligence are common and may persist years after treatment. Core deficits in attention, processing speed and working memory are postulated to underlie problems with overall intellectual development, academic achievement and career attainment. Additionally, psychological problems after PBT can include depression, anxiety and psychosocial adjustment issues. Several intervention paradigms are briefly described, though to date research on innovative, specific and effective interventions for neurocognitive late effects is still in its early stages. This article reviews the existing research for understanding PBT late effects and highlights the need for innovative research to enhance neurocognitive and psychosocial outcomes in PBT survivors.
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Affiliation(s)
- Peter L Stavinoha
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Martha A Askins
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Stephanie K Powell
- Ann and Robert H. Lurie Children's Hospital of Chicago and Northwestern Feinberg School of Medicine, Chicago, IL 60611, USA.
| | - Natasha Pillay Smiley
- Ann and Robert H. Lurie Children's Hospital of Chicago and Northwestern Feinberg School of Medicine, Chicago, IL 60611, USA.
| | - Rhonda S Robert
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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30
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Aljuhani SH, Bamaroof SA, Alghamdi TH, Almogbel AA, Alkhammash AS, Alkhammash BS, Bahusayn AA, Bangash MH, Baeesa SS, Chaudhary AG, Abuzenadah AM, Mirza AA, Saka MY, Hussein DM. Public awareness of central nervous system tumors in the Kingdom of Saudi Arabia. NEUROSCIENCES (RIYADH, SAUDI ARABIA) 2018; 23:227-237. [PMID: 30007999 PMCID: PMC8015579 DOI: 10.17712/nsj.2018.3.20180055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/14/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate individuals` knowledge about central nervous system tumors (CNST) signs and symptoms and risk factors, as well as their readiness to seek medical advice. The signs and symptoms associated with CNSTs are often vague, and failure to recognize them could lead to delays in seeking help and possibly fatal results. METHODS This was a cross-sectional survey that utilized 2 delivery methods. A total of 1,500 personally delivered and 1,500 online self-administered questionnaires were completed in parallel between June 2015 and June 2016 for the occupants of the Kingdom of Saudi Arabia. RESULTS Significant differences were observed for the sociodemographic characteristics of participants recruited via the 2 methods. The most recognized symptom was "Headaches" (45.2%), and the most recognized risk factor was "Radioactive location/occupation" (84.1%). Overall knowledge scores were low, significantly predicted by employment and cancer contact (p<0.05), while the scores significantly higher for participants who were willing to see their doctors within a week (p<0.005). The most recognized barrier to seeking help was "Worry about what the doctor might find" (74.0%). CONCLUSION The level of awareness of CNSTs was low. Using a questionnaire delivered in 2 different ways enabled the recruitment of sample pools with different sociodemographic characteristics.
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Affiliation(s)
- Shahad H. Aljuhani
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Saja A. Bamaroof
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Thoraya H. Alghamdi
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Alhanoof A. Almogbel
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Alhanof S. Alkhammash
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Batool S. Alkhammash
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Amjad A. Bahusayn
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Mohamad H. Bangash
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Saleh S. Baeesa
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Adeel G. Chaudhary
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Adel M. Abuzenadah
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed A. Mirza
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Mohamad Y. Saka
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Deema M. Hussein
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
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Bluschke A, von der Hagen M, Novotna B, Roessner V, Beste C. Executive Function Deficits in Seriously Ill Children-Emerging Challenges and Possibilities for Clinical Care. Front Pediatr 2018; 6:92. [PMID: 29721487 PMCID: PMC5915456 DOI: 10.3389/fped.2018.00092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 03/23/2018] [Indexed: 12/26/2022] Open
Abstract
The past years have seen an incredible increase in the quality and success rates of treatments in pediatric medicine. One of the resulting major challenges refers to the management of primary or secondary residual executive function deficits in affected children. These deficits lead to problems in the ability to acquire, understand, and apply abstract and complex knowledge and to plan, direct, and control actions. Executive functions deficits are important to consider because they are highly predictive of functioning in social and academic aspects of daily life. We argue that current clinical practice does not sufficiently account for the complex cognitive processes in this population. This is because widely applied pharmacological interventions only rarely account for the complexity of the underlying neuronal mechanisms and do not fit well into possibly powerful "individualized medicine" approaches. Novel treatment approaches targeting deficits in executive functions in seriously ill children could focus on neuronal oscillations, as these have some specific relations to different aspects of executive function. Importantly, such treatment approaches can be individually tailored to the individuals' deficits and can be transferred into home-treatment or e-health solutions. These approaches are easy-to-use, can be easily integrated into daily life, and are becoming increasingly cost-effective.
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Affiliation(s)
- Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Maja von der Hagen
- Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Barbara Novotna
- Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Experimental Neurobiology, National Institute of Mental Health, Prague, Czechia.,Institute of Psychology, Technische Universität Dresden, Dresden, Germany
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Abstract
We aimed to describe the quality of life (QOL) among parents of adolescent and young adult brain tumor survivors as well as parent, survivor, and diagnosis/treatment-related factors associated with adverse QOL. A cross-sectional study of 28 parents of adolescent and young adult brain tumor survivors (who were on average 10 y postdiagnosis) was used to assess QOL. Parent QOL was measured using the Patient-Reported Outcomes Measurement Information System Global Health measure. Factors associated with adverse parent QOL were explored using logistic regression including: parent, survivor, and diagnosis/treatment-related factors. Parent QOL was within the normal range; however, 40% scored below the clinical threshold of 0.5 SD below the mean for physical and mental health. Parent perceptions of greater family impact, survivor emotional/behavioral health problems, improved cognitive function, and recurrence were associated with adverse parent physical health. Parent anger/sorrow, uncertainty, survivor emotional/behavioral health problems, speech/language problems, and recurrence were associated with adverse parent mental health. Parental emotional resources and perceptions of improved survivor peer relationships were associated with greater parent physical and mental health. The impact of a brain tumor diagnosis and treatment on the QOL of parents may be significant. Interventions are needed to ensure that the needs of parents are met.
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33
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Azizi AA, Schouten-van Meeteren AYN. Current and emerging treatment strategies for children with progressive chiasmatic-hypothalamic glioma diagnosed as infants: a web-based survey. J Neurooncol 2017; 136:127-134. [PMID: 29071540 PMCID: PMC5754463 DOI: 10.1007/s11060-017-2630-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 10/04/2017] [Indexed: 10/26/2022]
Abstract
Treatment of infant hypothalamic chiasmatic glioma (iCHG) is challenging, about 30% of the children progress during chemotherapy. Despite subsequent treatments the 5 year overall-survival rate is only 70%. This study investigates treatment strategies currently applied for progressive iCHG. A web-based questionnaire was sent out to the members of the SIOPE Brain Tumour Group asking for current second and third line strategies at progression during and after the end of first line therapy. The questionnaire was answered by 47 paediatric oncologists from 15 countries. iCHG progressing during first line therapy with carboplatin-vincristine would be considered for treatment with alternative chemotherapy by 17 (36%) and with surgery plus chemotherapy by 27 respondents (58%). Components suggested for second line were vinblastine (62%), cisplatin (34%) and cyclophosphamide (26%). For third line therapy bevacizumab (BVZ) was considered as suitable by respondents in 53% (often with irinotecan 40%) and vinblastine by 34% respectively. Experience with BVZ in CHG is shown by 53% of respondents regarding at least 95 patients (median treated 1-5 patients per respondent at any age) with a median BVZ administration over 12 months. Effectiveness was reported varying between stable disease and regression while complications were rarely stated (proteinuria, hypertension, bleeding). BVZ would be available to 85% of respondents as therapeutic option for iCHG patients. Multiple anti-neoplastic drug regimens are applied for progressive iCHG, partly considered in combination with surgery if safely feasible. BVZ is commonly used at a satisfactory level in third line, mainly combined with irinotecan.
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Affiliation(s)
- Amedeo A Azizi
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
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Vanclooster S, Bilsen J, Peremans L, Van der Werff Ten Bosch J, Laureys G, Willems E, Genin S, Van Bogaert P, Paquier P, Jansen A. Attending school after treatment for a brain tumor: Experiences of children and key figures. J Health Psychol 2017; 24:1436-1447. [DOI: 10.1177/1359105317733534] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Reintegration into school is a milestone for childhood brain tumor survivors, as well as for their parents, teachers, and healthcare providers. We explored their experiences following the school re-entry by conducting semi-structured interviews. Thematic analysis resulted in four main themes: “school performance,” “psychosocial well-being,” “support and approach,” and “communication and collaboration.” Children were pleased to return to school despite confrontation with adverse outcomes. Parents, teachers, and healthcare providers identified current and future concerns and challenges, as well as opportunities for academic and personal development. Their experiences highlight the importance of coordinated and systematic follow-up in close collaboration with healthcare providers.
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Affiliation(s)
- Stephanie Vanclooster
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lieve Peremans
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
| | | | - Geneviève Laureys
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Elsie Willems
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Sophie Genin
- Department of Neuropsychology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Patrick Van Bogaert
- Department of Pediatric Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Philippe Paquier
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
- Unit of Clinical and Experimental Neurolinguistics, Center for Linguistics, Vrije Universiteit Brussel, Brussels, Belgium
- Unit of Translational Neurosciences, School of Medicine and Health Sciences, Universiteit Antwerpen, Antwerp, Belgium
| | - Anna Jansen
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Pediatric Neurology Unit, Department of Pediatrics, UZ Brussel, Brussels, Belgium
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Lai JS, Beaumont JL, Nowinski CJ, Cella D, Hartsell WF, Han-Chih Chang J, Manley PE, Goldman S. Computerized Adaptive Testing in Pediatric Brain Tumor Clinics. J Pain Symptom Manage 2017; 54:289-297. [PMID: 28797854 PMCID: PMC5610102 DOI: 10.1016/j.jpainsymman.2017.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/20/2017] [Accepted: 05/25/2017] [Indexed: 12/23/2022]
Abstract
CONTEXT Monitoring of health-related quality of life and symptoms of patients with brain tumors is needed yet not always feasible. This is partially due to lack of brief-yet-precise assessments with minimal administration burden that are easily incorporated into clinics. Dynamic computerized adaptive testing (CAT) or static fixed-length short forms, derived from psychometrically sound item banks, are designed to fill this void. OBJECTIVE This study evaluated the comparability of scores obtained from CATs and short forms. METHODS Patients (ages 7-22 years) were recruited from brain tumor clinics and completed Patient-Reported Outcome Measurement Information System CATs and short forms (Fatigue, Mobility, Upper Extremity, Depressive Symptoms, Anxiety, and Peer Relationships). Pearson correlations, paired t-tests, and Cohen's d were used to evaluate the relationship, significant differences, and the magnitude of the difference between these two scores, respectively. RESULTS Data from 161 patients with brain tumors were analyzed. Patients completed each CAT within 2 minutes. Scores obtained from CATs and short forms were highly correlated (r = 0.95-0.98). Significantly different CAT vs. short-form scores were found on 4 (of 6) domains yet with negligible effect sizes (|d| < 0.09). These relationships varied across patients with different levels of reported symptoms, with the strongest association at the worst or best symptom scores. CONCLUSIONS This study demonstrated the comparability of scores from CATs and short forms. Yet the agreement between these two varied across degrees of symptom severity which was a result of the ceiling effects of static short forms. We recommend CATs to enable individualized assessment for longitudinal monitoring.
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Affiliation(s)
- Jin-Shei Lai
- Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
| | - Jennifer L Beaumont
- Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Cindy J Nowinski
- Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - David Cella
- Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - William F Hartsell
- Northwestern Medicine Chicago Proton Center, Warrenville, Illinois, USA; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - John Han-Chih Chang
- Northwestern Medicine Chicago Proton Center, Warrenville, Illinois, USA; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Peter E Manley
- Children's Hospital Boston and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Stewart Goldman
- Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
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36
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Schulte F, Russell KB, Cullen P, Embry L, Fay-McClymont T, Johnston D, Rosenberg AR, Sung L. Systematic review and meta-analysis of health-related quality of life in pediatric CNS tumor survivors. Pediatr Blood Cancer 2017; 64. [PMID: 28266804 DOI: 10.1002/pbc.26442] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/10/2016] [Accepted: 12/12/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pediatric central nervous system (CNS) tumor survivors are at high risk for numerous late effects including decreased health-related quality of life (HRQOL). Our objective was to summarize studies describing HRQOL in pediatric CNS tumor survivors and compare HRQOL outcomes in studies that included a comparison group. PROCEDURE EMBASE, MEDLINE, and PsychINFO were used to identify relevant articles published until August, 2016. Eligible studies reported outcomes for pediatric CNS tumor survivors diagnosed before age 21, at least 5 years from diagnosis and/or 2 years off therapy and used a standardized measure of HRQOL. All data were abstracted by two reviewers. Random-effects meta-analyses were performed using Review Manager 5.0. RESULTS Of 1,912 unique articles identified, 74 were included in this review. Papers described 29 different HRQOL tools. Meta-analyses compared pediatric CNS tumor survivors to healthy comparisons and other pediatric cancer survivors separately. HRQOL was significantly lower for CNS (n = 797) than healthy comparisons (n = 1,397) (mean difference = -0.54, 95% confidence interval [CI] = -0.72 to -0.35, P < 0.001, I2 = 35%). HRQOL was also significantly lower for CNS (n = 244) than non-CNS survivors (n = 414) (mean difference = -0.56, 95% CI = -0.73 to -0.38, P < 0.00001, I2 = 0%). CONCLUSIONS Pediatric CNS tumor survivors experience worse HRQOL than healthy comparisons and non-CNS cancer survivors. Future HRQOL work should be longitudinal, and/or multisite studies that examine HRQOL by diagnosis and treatment modalities.
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Affiliation(s)
- Fiona Schulte
- Departments of Oncology and Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Haematology, Oncology and Transplant Program, Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - K Brooke Russell
- Haematology, Oncology and Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada.,Departments of Oncology and Psychology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Patricia Cullen
- Loretto Heights School of Nursing, Regis University, Denver, Colorado
| | - Leanne Embry
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Taryn Fay-McClymont
- Departments of Oncology and Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Donna Johnston
- Department of Haematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Abby R Rosenberg
- Department of Hematology/Oncology, Seattle Children's Hospital, Seattle, Washington
| | - Lillian Sung
- Department of Haematology/Oncology, SickKids Hospital, Toronto, Ontario, Canada
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37
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de Vries M, de Ruiter MA, Oostrom KJ, Schouten-Van Meeteren AYN, Maurice-Stam H, Oosterlaan J, Grootenhuis MA. The association between the behavior rating inventory of executive functioning and cognitive testing in children diagnosed with a brain tumor. Child Neuropsychol 2017; 24:844-858. [PMID: 28693404 DOI: 10.1080/09297049.2017.1350262] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Pediatric brain tumor survivors (PBTS) suffer from cognitive late effects, such as deteriorating executive functioning (EF). We explored the suitability of the Behavior Rating Inventory of Executive Function (BRIEF) to screen for these late effects. We assessed the relationship between the BRIEF and EF tasks, and between the BRIEF-Parent and BRIEF-Teacher, and we explored the clinical utility. Eighty-two PBTS (8-18 years) were assessed with EF tasks measuring attention, cognitive flexibility, inhibition, visual-, and working memory (WM), and with the BRIEF-Parent and BRIEF-Teacher. Pearson's correlations between the BRIEF and EF tasks, and between the BRIEF-Parent and BRIEF-Teacher were calculated. The BRIEF-Parent related poorly to EF tasks (rs < .26, ps > .01), but of the BRIEF-Teacher the WM-scale, Monitor-scale, Behavioral-Regulation-Index, and Meta-cognition-Index, and Total-score (rs > .31, ps < .01) related significantly to some EF tasks. When controlling for age, only the WM scale and Total score related significantly to the attention task (ps < .01). The inhibit scales of the BRIEF-Parent and BRIEF-Teacher correlated significantly (r = .33, p < .01). Children with clinically elevated scores on BRIEF scales that correlated with EF tasks performed worse on all EF tasks (ds 0.56-1.23, ps < .05). The BRIEF-Teacher Total and Index scores might better screen general EF in PBTS than the BRIEF-Parent. However, the BRIEF-Teacher is also not specific enough to capture separate EFs. Solely relying on the BRIEF as a screening measure of EFs in BPTS is insufficient. Questionnaires and tasks give distinctive, valuable information.
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Affiliation(s)
- M de Vries
- a Research Priority Area Yield , University of Amsterdam, Amsterdam, The Netherlands.,b University of Nottingham - Malaysia Campus, School of Psychology, Semenyih, Selangor, Malaysia.,c Emma Children's Hospital, AMC, Psychosocial Department, Amsterdam, The Netherlands.,d Department of Medical Psychology, VU University Medical Center , Amsterdam, The Netherlands
| | - M A de Ruiter
- c Emma Children's Hospital, AMC, Psychosocial Department, Amsterdam, The Netherlands
| | - K J Oostrom
- c Emma Children's Hospital, AMC, Psychosocial Department, Amsterdam, The Netherlands.,d Department of Medical Psychology, VU University Medical Center , Amsterdam, The Netherlands
| | | | - H Maurice-Stam
- c Emma Children's Hospital, AMC, Psychosocial Department, Amsterdam, The Netherlands
| | - J Oosterlaan
- f Emma Children's Hospital, AMC, Amsterdam , The Netherlands.,g Department of Clinical Neuropsychology, VU University , Amsterdam, The Netherlands
| | - M A Grootenhuis
- c Emma Children's Hospital, AMC, Psychosocial Department, Amsterdam, The Netherlands.,h Princess Maxima Center for pediatric oncology, Utrecht, The Netherlands
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Prevention of radiotherapy-induced neurocognitive dysfunction in survivors of paediatric brain tumours: the potential role of modern imaging and radiotherapy techniques. Lancet Oncol 2017; 18:e91-e100. [DOI: 10.1016/s1470-2045(17)30030-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 10/24/2016] [Accepted: 10/26/2016] [Indexed: 02/06/2023]
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Al-Gamal E, Long T. Health-related quality of life and its association with self-esteem and fatigue among children diagnosed with cancer. J Clin Nurs 2016; 25:3391-3399. [DOI: 10.1111/jocn.13467] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Ekhlas Al-Gamal
- Psychiatric and Mental Health Nursing; Faculty of Nursing; The University of Jordan; Amman Jordan
- Psychiatric and Mental Health Nursing; College of Nursing; Ministry of National Guard Health Affairs; King Saud bin Abdulaziz University for Health Sciences; Riyadh Kingdom of Saudi Arabia
| | - Tony Long
- Child and Family Health; School of Nursing, Midwifery & Social Work; University of Salford; Salford UK
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