Adverse medical events associated with childhood cerebellar astrocytomas and medulloblastomas: natural history and relation to very long-term neurobehavioral outcome.
OBJECTIVE
The objectives of the study are to document the incidence of medical events in survivors of childhood posterior fossa astrocytoma or medulloblastoma in four time periods (diagnosis, perioperative, short-term survival, long-term survival), and to study whether medical events predict neurobehavioral outcome.


METHODS
Twenty-nine astrocytoma and 29 medulloblastoma survivors were studied at least 5 years post-diagnosis. The incidence of medical events in each time period was compared in each group in relation to long-term intelligence, memory, functional independence, and health-related quality of life. As expected, medical and neurobehavioral outcome were poorer in the medulloblastoma group. In the astrocytoma group, poorer long-term neurobehavioral outcome was associated with more adverse medical events in the perioperative and short-term survival periods.


CONCLUSIONS
Long-term neurobehavioral outcome is related to time-dependent medical events in astrocytoma survivors. The data confirm earlier reports of poorer outcome after medulloblastoma and add new information about clinical markers of poor neurobehavioral outcome in survivors of childhood astrocytoma.
Roncadin
Caroline
C
Peel Children's Centre, 85A Aventura Court, Mississauga, ON, L5T 2Y6, Canada. croncadin@peelcc.org
Dennis
Maureen
M
Greenberg
Mark L
ML
Spiegler
Brenda J
BJ
D017668:Age of Onset; D001254:Astrocytoma / Q000150:complications* / Q000628:therapy; D002528:Cerebellar Neoplasms / Q000150:complications* / Q000628:therapy; D002675:Child, Preschool; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000150:complications* / Q000628:therapy; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology; D011788:Quality of Life; D017741:Survivors / Q000706:statistics & numerical data*