title: Neurological outcome of childhood brain tumor survivors.
abstract: We assessed neurological and neurocognitive outcome in childhood brain tumor survivors. Altogether, 75 out of 80 brain tumor survivors diagnosed below 17 years between 1983 and 1997; and treated in Tampere University Hospital, Finland, were invited to participate in this population-based cross-sectional study. Fifty-two (69%) participated [mean age 14.2 (3.8-28.7) years, mean follow-up 7.5 (1.5-15.1) years]. Neurological status was abnormal in 69% cases. All were ambulatory, but only 50% showed normal motor function. Twenty-nine percent showed clumsiness/mild asymmetry and 21% hemiparesis. One suffered from intractable epilepsy. According to structured interview, 87% coped normally in daily living. Median full-scale IQ was 85 (39-110) in 21 6-16 year olds (70%); in 29% IQ was <70. Thirty of the 44 school-aged subjects attended school with normal syllabus and 32% needed special education. Six of the 16 patients over 18 years of age were working. Regarding quality of life, 38% were active without disability, 33% active with mild disability, 21% were partially disabled, but capable of self-care, and 8% had severe disability, being incapable of self-care. Supratentorial/hemispheric tumor location, tumor reoperations, shunt revisions and chemotherapy were associated with neurological, cognitive and social disabilities. In conclusion, of the 52 survivors, neurological status was abnormal in 69%; 71% lived an active life with minor disabilities, 29% had major neurological, cognitive and social disabilities, and 8% of them were incapable of self-care. Predictors of these disabilities included supratentorial/hemispheric tumor location, tumor reoperations, shunt revisions and chemotherapy. Survivors need life-long, tailor-made multiprofessional support and follow-up.
authors.affiliation: Department of Pediatrics, Tampere University Hospital, P.O. Box 2000, 33521, Tampere, Finland. sari.pietila@sci.fi
authors.forename: Sari
authors.initials: S
authors.lastname: Pietilä
authors.forename: Raija
authors.initials: R
authors.lastname: Korpela
authors.forename: Hanna L
authors.initials: HL
authors.lastname: Lenko
authors.forename: Hannu
authors.initials: H
authors.lastname: Haapasalo
authors.forename: Riitta
authors.initials: R
authors.lastname: Alalantela
authors.forename: Pirkko
authors.initials: P
authors.lastname: Nieminen
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Koivisto
authors.forename: Anne
authors.initials: A
authors.lastname: Mäkipernaa
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000970:Antineoplastic Agents; D001932:Brain Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology* / Q000534:rehabilitation; D004522:Educational Status; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology* / Q000534:rehabilitation; D011788:Quality of Life; D011878:Radiotherapy; D012189:Retrospective Studies; D017741:Survivors
chemical_list: D000970:Antineoplastic Agents