Long-term Functional Outcome in Young Adult Survivors of Childhood Brain Tumor

Abstract

Background and Objective: The late effects of childhood brain tumors (BTs) are extensively described in the literature. However, their effect on independent living skills of survivors is not. Therefore, the aim of this study is to assess the impact of late effects of childhood BT and related treatment on the performance in daily living activities of survivors. Furthermore, we wanted to determine which factors are likely to be associated with performance limitation. Methods: A cross-sectional study was conducted. Setting: Follow-up clinic in a tertiary care university hospital. Patients: Young adult survivors of childhood BT. Intervention and Measurements: No intervention was delivered. Performance in activities of daily living (ADL) was measured by the Assessment of Motor and Process Skills 5 years or more after diagnosis. Sociodemographic and medical information was also collected. Results: Thirty-six young adults, mean age 21.0 years (range, 16-29 years) and mean time since completion of treatment 10.1 years (range, 4.0-18.0 years), participated in this study. Results showed that 55% of the participants had results under the motor cutoff and 36% under both the motor and process cutoffs representing the lower limit of competent ADL task performance. Lower level of functioning was associated with younger age at diagnosis for process skills and tumor location (odds ratio [OR] = 9.0; 95% confidence interval [CI], 1.97-41.08), female gender (OR = 5.14; 95% CI, 1.18-22.48), longer time since treatment (OR = 0.2; 95% CI, 0.05-0.08), and multiple chronic health conditions (OR = 0.06; 95%CI, 0.01-0.51) for motor skills. Limitations: The study design does not allow to make causal inference. Conclusions: Five years or more after diagnosis, survivors of pediatric BT show decreased motor and process skills affecting their performance in ADL. Recommendations from this study include the development of effective rehabilitation and prevention programs to optimize their functional outcome and to target patients at heightened risk for follow-up.