Outcome of medulloblastoma in children: long-term complications and quality of life.
To study the outcomes in long-term survivors of paediatric medulloblastoma (MB), we followed 51 consecutive children who were treated between 1980 and 2000 in a single institution. In 18 of 26 survivors (mean follow-up time 12.2 years), tumour control, neurological, endocrine, and neurocognitive complications and their impact on behavioural and psychological adjustment, and health-related quality of life (QoL) were comprehensively assessed using qualitative and quantitative measures. Endocrine deficits occurred in 61 %, neurological complications in 72 %, and significant school problems in 72 %. All patients had significant deficits in neurocognitive functioning: attention and processing speed was impaired in 79 %, learning and memory in 88 %, language in 56 %, visual perception in 50 %, and executive functions in 64 %. In comparison with healthy controls, social functioning was rated by the patients as the QoL dimension most affected. Parents' ratings were considerably lower than those of the patients. No MB survivor > 18 years of age (n = 12) had a boy- or girlfriend. Because of their treatment, including craniospinal radiotherapy, MB long-time survivors are not only at great risk for neurological, endocrine, and neurocognitive complications, but also of social isolation thereby decreasing self-rated QoL substantially.
Ribi
K
K
Division of Oncology, University Children's Hospital of Zurich, Zurich, Switzerland.
Relly
C
C
Landolt
M A
MA
Alber
F D
FD
Boltshauser
E
E
Grotzer
M A
MA
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D002528:Cerebellar Neoplasms / Q000503:physiopathology / Q000523:psychology*; D002648:Child; D018450:Disease Progression; D004703:Endocrine System / Q000503:physiopathology; D005260:Female; D006801:Humans; D007360:Intelligence; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008527:Medulloblastoma / Q000503:physiopathology / Q000523:psychology*; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012189:Retrospective Studies; D012919:Social Behavior; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors