Long-term sequelae in children treated for brain tumors: impairments, disability, and handicap.
Sixty-one long-term survivors, treated for brain tumors in childhood, were evaluated in term of neurological impairments, disability, and handicap. Thirty-eight patients (pts) (62%) had at least one impairment. Visual impairment was detected in 14 pts (24%), associated with recurrence (p = .012). Thirty-four patients (56%) had motor impairment, associated with sex (female) in irradiated patients; 13 (21%) had epilepsy, associated with supratentorial tumor site (p = .001). The same number of patients had brain atrophy; risk factors were hydrocephalus at diagnosis and perioperative complications. Sixteen patients (30%) had IQ score < 80, associated with young age at first treatment (p = .006) and recurrence (p = .043). Twenty-seven out of 61 of our patients (44%) were disabled: 12 mildly, 14 moderately, and 1 severely. Epilepsy was the most important risk factor for disability. Cognitive impairment, motor impairment, and epilepsy were associated with employment (43%); cognitive impairment was also associated with education.
Macedoni-Luksic
Marta
M
Department of Child Neurology, University Pediatric Hospital, Ljubljana, Slovenia. marta.macedoni-luksic@uni.m-lj.si
Jereb
Berta
B
Todorovski
Lupco
L
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001284:Atrophy; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000528:radiation effects; D001925:Brain Damage, Chronic / Q000453:epidemiology / Q000209:etiology*; D001932:Brain Neoplasms / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002114:Calcinosis / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D016371:Cranial Irradiation / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D019988:Children with Disabilities / Q000523:psychology; D004827:Epilepsy / Q000453:epidemiology / Q000209:etiology; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000453:epidemiology / Q000209:etiology; D007223:Infant; D008607:Intellectual Disability / Q000453:epidemiology / Q000209:etiology; D007859:Learning Disabilities / Q000453:epidemiology / Q000209:etiology; D008130:Lomustine / Q000008:administration & dosage / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D009069:Movement Disorders / Q000453:epidemiology / Q000209:etiology; D009364:Neoplasm Recurrence, Local; D015995:Prevalence; D011344:Procarbazine / Q000008:administration & dosage / Q000009:adverse effects; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology; D017524:Slovenia / Q000453:epidemiology; D017741:Survivors / Q000523:psychology; D014057:Tomography, X-Ray Computed; D014478:Unemployment / Q000706:statistics & numerical data; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects; D014786:Vision Disorders / Q000453:epidemiology / Q000209:etiology
D011344:Procarbazine; D014750:Vincristine; D005047:Etoposide; D008130:Lomustine; D003520:Cyclophosphamide; D002945:Cisplatin; D008727:Methotrexate