What Happens after Therapy? Quality of Life and Neurocognitive Functions of Children with Malignant Posterior Fossa Tumors after Adjuvant Therapy.

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  • Additional Information
    • Source:
      Publisher: Medknow Publications Country of Publication: India NLM ID: 0042005 Publication Model: Print Cited Medium: Internet ISSN: 1998-4022 (Electronic) Linking ISSN: 00283886 NLM ISO Abbreviation: Neurol India Subsets: MEDLINE
    • Publication Information:
      Publication: Mumbai : Medknow Publications
      Original Publication: Bombay : Neurological Society of India
    • Subject Terms:
      Cerebellar Neoplasms* ; Infratentorial Neoplasms*/therapy ; Medulloblastoma*; Adolescent ; Child ; Child, Preschool ; Cross-Sectional Studies ; Humans ; Infant ; Quality of Life
    • Abstract:
      Purpose: The health-related quality of life (HRQoL) is an important endpoint in modern clinical practice with improved survival of pediatric posterior fossa malignant brain tumors (PFMBTs). We evaluated the effect of environmental and psychosocial milieu on QoL and cognitive functioning (CF) of Indian children with PFMBT.
      Methods: In a cross-sectional study, 47 children <18 years of age with medulloblastoma or anaplastic ependymoma were evaluated ≥6 months after completion of adjuvant therapy. All clinical and socioeconomic details, educational status of child and family members, socioeconomic status, environmental factors affecting QoL were documented. Children underwent HRQoL evaluation using Pediatric quality of life Inventory (PedsQL) questionnaire and neuropsychological evaluation.
      Results: The median age of the cohort at presentation was 7 years (1-18) and median duration of evaluation after adjuvant therapy was 16 months. In 47 families, 72.34% had low monthly income and 76.6% of mothers took formal education. QoL scores were above median values. Parents reported scores highlighted that Lansky performance score (P = 0.001) and maternal education (P = 0.043) significantly influenced the cognitive component of QoL. Twenty-seven children had below-average IQ. Young age at presentation (P = 0.020), maternal education (P = 0.032), high socioeconomic status (P = 0.001) influenced the IQ score. Even though the majority of children (57.44%) had below-average IQ, they had a score of more than 50 on the cognitive functioning scale. A total of 72.5% of the eligible children in our cohort went back to school following therapy, though often with a delay of one academic year.
      Conclusions: Overall cognitive functioning scores of these children are good, but they are not representative of actual neurocognitive tasks based performance or IQ scores. Children should remain under regular follow-up with a neurocognitive assessment and psychological counseling at regular intervals.
      Competing Interests: None
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    • Grant Information:
      IA/CPHI/17/1/503348 India WTDBT_ DBT-Wellcome Trust India Alliance
    • Contributed Indexing:
      Keywords: Cognitive function; IQ; children; ependymoma; medulloblastoma; neuropsychology; posterior fossa tumor; quality of life
    • Publication Date:
      Date Created: 20211108 Date Completed: 20211110 Latest Revision: 20220725
    • Publication Date:
      20221213
    • Accession Number:
      PMC7613140
    • Accession Number:
      10.4103/0028-3886.329599
    • Accession Number:
      34747802