Neuro-Oncology: Neurological outcome of childhood brain tumor survivors

Saturday, February 25, 2012

Neurological outcome of childhood brain tumor survivors

Abstract

We assessed neurological and neurocognitive outcome in childhood brain tumor survivors. Altogether, 75 out of 80 brain tumor survivors diagnosed below 17 years between 1983 and 1997; and treated in Tampere University Hospital, Finland, were invited to participate in this population-based cross-sectional study. Fifty-two (69%) participated [mean age 14.2 (3.8–28.7) years, mean follow-up 7.5 (1.5–15.1) years]. Neurological status was abnormal in 69% cases. All were ambulatory, but only 50% showed normal motor function. Twenty-nine percent showed clumsiness/mild asymmetry and 21% hemiparesis. One suffered from intractable epilepsy. According to structured interview, 87% coped normally in daily living. Median full-scale IQ was 85 (39–110) in 21 6–16 year olds (70%); in 29% IQ was <70. Thirty of the 44 school-aged subjects attended school with normal syllabus and 32% needed special education. Six of the 16 patients over 18 years of age were working. Regarding quality of life, 38% were active without disability, 33% active with mild disability, 21% were partially disabled, but capable of self-care, and 8% had severe disability, being incapable of self-care. Supratentorial/hemispheric tumor location, tumor reoperations, shunt revisions and chemotherapy were associated with neurological, cognitive and social disabilities. In conclusion, of the 52 survivors, neurological status was abnormal in 69%; 71% lived an active life with minor disabilities, 29% had major neurological, cognitive and social disabilities, and 8% of them were incapable of self-care. Predictors of these disabilities included supratentorial/hemispheric tumor location, tumor reoperations, shunt revisions and chemotherapy. Survivors need life-long, tailor-made multiprofessional support and follow-up.

Content Type Journal Article
Category Clinical Study
Pages 1-9
DOI 10.1007/s11060-012-0816-5
Authors
- Sari Pietilä, Department of Pediatrics, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland
- Raija Korpela, Department of Pediatrics, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland
- Hanna L. Lenko, Department of Pediatrics, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland
- Hannu Haapasalo, Department of Pathology, Centre for Laboratory Medicine, Tampere University Hospital, Tampere, Finland
- Riitta Alalantela, School of Humanities and Social Sciences, University of Tampere, Tampere, Finland
- Pirkko Nieminen, School of Humanities and Social Sciences, University of Tampere, Tampere, Finland
- Anna-Maija Koivisto, Tampere School of Public Health, University of Tampere, Tampere, Finland
- Anne Mäkipernaa, Department of Medicine, Division of Hematology, Coagulation Disorders, Helsinki University Central Hospital, Helsinki, Finland