Neuropsychological performance and quality of life of 10 year survivors of childhood medulloblastoma.
OBJECTIVE
Survivors of medulloblastoma, the most frequently occurring malignant brain tumor of childhood, suffer neuropsychological damage in the first decade after diagnosis. Cognitive performance, psychosocial functioning and quality of life were assessed in medulloblastoma survivors in the second decade after diagnosis.


METHODS
Ten year survivors were evaluated with a battery of neuropsychological tests, and self-report questionnaires regarding quality of life and emotional functioning. Clinical variables examined included the patient's age at diagnosis, duration since diagnosis, treatment, and complications.


RESULTS
Sixteen medulloblastoma survivors [mean age at diagnosis: 7.2 years, range: 1-15 years; 6 males] were tested at a mean age of 22.2 years [range: 13.6-27.9 years]. All survivors had been treated with craniospinal radiation therapy; nine were treated with chemotherapy. Significant impairments were identified in more than 50 of survivors on tests within all neuropsychological domains, including attention, memory, visuospatial abilities, motor functioning, language, and executive functioning. Significant impairments were also identified in all psychosocial domains examined, including employment, ability to drive an automobile, participation in normal education, independent living, and dating history. Most importantly, quality of life scores, reported by both survivors and their caretakers, were in the normal range.


CONCLUSIONS
Survivors of childhood medulloblastoma frequently suffer severe persistent deficits in a wide-range of neuropsychological functional domains. Nevertheless, survivors and their families do not report impaired quality of life. These severe neuropsychological and psychosocial deficiencies justify further attempts to reduce or delay the use of craniospinal radiation therapy for childhood medulloblastoma.
Maddrey
Ann M
AM
Division of Consult Liaison & Behavioral Medicine, Department of Psychiatry, U.T. Southwestern Medical Center, The Annette Strauss Center for Neuro-Oncology, 5323 Harry Hines Blvd, Dallas, TX 75390-8898, USA. ann.maddrey@utsouthwestern.edu
Bergeron
Jon A
JA
Lombardo
Elizabeth R
ER
McDonald
Noelle K
NK
Mulne
Arlynn F
AF
Barenberg
Paul D
PD
Bowers
Daniel C
DC
D000203:Activities of Daily Living; D000328:Adult; D002528:Cerebellar Neoplasms / Q000523:psychology*; D002648:Child; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D004493:Education; D004651:Employment; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D007398:Interpersonal Relations; D008297:Male; D008527:Medulloblastoma / Q000523:psychology*; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*