Abstract
PurposeSurvivors of childhood brain tumors (BT) are at high risk for long-term physical and psychological sequelae. Still, knowledge about health-related quality of life (HRQL) and associated factors in this population is sparse. This study investigated HRQL and its predictors in long-term survivors of childhood BT.MethodsSurvivors of childhood BT (mean age = 28.1 years, SD = 6.8, n = 60) underwent clinical examination and neurocognitive examination, and completed self-rating questionnaires assessing HRQL (RAND-36) and depressive symptoms (Beck Depression Inventory-II). Socio-demographic information was gathered via a questionnaire. Tumor- and treatment-related information was collected from medical records. Control group data were collected from age-matched controls (n = 146) without a history of cancer, randomly selected from the local population registry. Multiple linear regression models were used to investigate predictors of HRQL; separate models were fitted for each domain of the RAND-36.ResultsMale survivors (mean age = 27.0, SD = 6.0, n = 39) reported significantly lower HRQL than male controls in the domains of physical functioning, general health, vitality, social functioning, and role limitations-emotional. Female survivors (mean age = 30.2 years, SD = 7.6, n = 21) reported comparable levels as female controls in all domains except physical functioning. A higher burden of late effects, not working/studying, being diagnosed with BT during adolescence, and reporting current depressive symptoms were significant predictors of lower HRQL.ConclusionOur results highlight that male survivors of childhood BT are at particular risk of impaired HRQL. Also, results point to the close relation between symptoms of depression and impaired HRQL in survivors of childhood BT which should be acknowledged by long-term follow-up care.
Highlights
The survival rate for childhood brain tumors (BT) in the Nordic countries is approaching 80% [1]
BT survivors reported significantly lower scores than controls in the following five dimensions: physical functioning (p < 0.05); general health (p < 0.05); vitality (p < 0.01); social functioning (p < 0.05); and role limitations caused by emotional problems (p < 0.05)
Results showed that male survivors report significantly lower health-related quality of life (HRQL) than male controls in five of the eight domains of HRQL: physical functioning, general health, vitality, social functioning, and role limitations caused by emotional problems
Summary
The survival rate for childhood brain tumors (BT) in the Nordic countries is approaching 80% [1]. With an increased number of long-term survivors, the focus on late effects and quality of survival has increased [2]. Compared to survivors of other childhood malignancies, childhood BT survivors are well-known to be at higher risk of serious medical illnesses, functional impairment, and late mortality [3–5]. Medical conditions commonly reported in this population include endocrinological, cardiovascular, and cerebrovascular late effects, as well as cognitive impairment and sensory health conditions [4, 6]. BT survivors report higher rates of attention deficits, peer conflict, social withdrawal, and antisocial behavior [8]. Despite all these well-documented common impairments in physical, neurocognitive, and psychosocial function, firm knowledge about health-related quality of life (HRQL) in long-term survivors of childhood BT is lacking
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