title: Impact of late effects on health-related quality of life in survivors of pediatric brain tumors: motility disturbance of limb(s), seizure, ocular/visual impairment, endocrine abnormality, and higher brain dysfunction.
abstract: BACKGROUND
  Survivors of pediatric brain tumors are often affected by late effects, such as motility disturbance of limb(s), seizure, ocular/visual impairment, endocrine abnormality, and higher brain dysfunction, resulting from the disease and its treatment. Appropriate provision of supportive care will require understanding the effects of these experiences on survivors' health-related quality of life (HRQOL).
  
  
  OBJECTIVE
  The aim of this study was to identify the relationships between late effects and specific aspects of the HRQOL of pediatric brain tumor survivors.
  
  
  METHODS
  We distributed questionnaires for measuring HRQOL to 138 survivors and their parents at 8 hospitals and 1 clinic in Japan and simultaneously surveyed late effects using information provided by the survivors' attending physicians. We compared the HRQOL of survivors with and survivors without specific late effects.
  
  
  RESULTS
  A total of 106 survivors and their parents returned the questionnaires to the researchers. The HRQOL of survivors 18 years or older was negatively affected by all 5 late effects, indicating that their higher impairment was associated with diminished HRQOL. The HRQOL of survivors aged 12 to 17 years was negatively affected by 2 late effects (ocular/visual impairment and motility disturbance of the limbs). A part of the HRQOL subdomain (motor and cognitive functioning) of survivors aged 12 to 17 years was positively related to ocular/visual impairment.
  
  
  CONCLUSIONS
  Five late effects influenced the HRQOL of pediatric brain tumor survivors.
  
  
  CONCLUSIONS
  Nurses and other health professionals should provide specific care designed to support aspects of HRQOL affected by late effects. For example, survivors with ocular/visual impairment may be expected to require additional emotional support, and those with seizures or endocrine abnormalities may be expected to require additional support for sleep disorders.
authors.affiliation: Author Affiliations: Department of Family Nursing, Graduate School of Health Sciences and Nursing, Faculty of Medicine, The University of Tokyo, Japan (Drs Sato and Kamibeppu and Mss Higuchi and Murayama); Children'sCancer Association of Japan, Tokyo, (Ms Higuchi); Department of Neuro-oncology/Neurosurgery, Division of Pediatric Neuro-oncology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan (Dr Yanagisawa); Departments of Neurosurgery, Tohoku University Graduate School of Medicine, Japan (Dr Kumabe); Department of Clinical Oncology & Neuro-oncology Program, Cancer Treatment Center, Hiroshima University Hospital, Japan (Dr Sugiyama); Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Japan (Drs Mukasa and Saito); Sawamura Neurosurgery Clinic, Sapporo, Japan (Dr Sawamura); Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan (Dr Terasaki); Neurosurgery and Neuro-oncology Division, National Cancer Center Hospital, Tokyo, Japan (Dr Shibui); Department of Neurosurgery, Tazuke Kofukai Medical Research Institute and Kitano Hospital, Osaka, Japan (Dr Takahashi); Department of Neuro-oncology/Neurosurgery, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Japan (Dr Nishikawa); and Center for Child Health, Prefectural Central Hospital, Ehime, Japan (Dr Ishida).
authors.forename: Iori
authors.initials: I
authors.lastname: Sato
authors.forename: Akiko
authors.initials: A
authors.lastname: Higuchi
authors.forename: Takaaki
authors.initials: T
authors.lastname: Yanagisawa
authors.forename: Shiho
authors.initials: S
authors.lastname: Murayama
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kumabe
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Sugiyama
authors.forename: Akitake
authors.initials: A
authors.lastname: Mukasa
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Saito
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sawamura
authors.forename: Mizuhiko
authors.initials: M
authors.lastname: Terasaki
authors.forename: Soichiro
authors.initials: S
authors.lastname: Shibui
authors.forename: Jun
authors.initials: J
authors.lastname: Takahashi
authors.forename: Ryo
authors.initials: R
authors.lastname: Nishikawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ishida
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Kamibeppu
mesh_terms: D000293:Adolescent; D001259:Ataxia / Q000150:complications / Q000523:psychology; D001927:Brain Diseases / Q000150:complications / Q000523:psychology; D001932:Brain Neoplasms / Q000150:complications*; D002648:Child; D004700:Endocrine System Diseases / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D000068079:Motor Disorders / Q000150:complications / Q000523:psychology; D010372:Pediatrics; D011788:Quality of Life / Q000523:psychology*; D012640:Seizures / Q000150:complications / Q000523:psychology; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000150:complications / Q000523:psychology