title: Health-related Quality of Life in Long-term Survivors of Brain Tumors in Childhood and Adolescence: A Serial Study Spanning a Decade.
abstract: Survivors of brain tumors in childhood experience adverse sequelae that are greater in prevalence and severity than those encountered by survivors of all other forms of cancer in early life, reflected in a burden of morbidity by instruments measuring health-related quality of life (HRQL). However, there are few studies of the change in HRQL over time in such populations. Patients who were above 5 years of age, at least 2 years from completion of therapy, and able to communicate in English were eligible for study of HRQL by the Health Utilities Index HUI2 and HUI3 at study entry, and again 5 and 10 years later. An initial cohort of 40 patients was reduced to 37 and 25 at the second and third time points, respectively, although only 1 death occurred during the study. HRQL showed a progressive decline over the decade, reaching conventional levels of clinical significance for the sizes of the changes. Median scores for HUI2 were 0.93, 0.90, and 0.88; and for HUI3 were 0.88, 0.85, and 0.77 at baseline, 5, and 10 years, respectively. The serial decline in HRQL demands further examination and an exploration of potential targets for therapeutic intervention.
authors.affiliation: *Service of Hematology-Oncology §Service of Surgery, McMaster Children's Hospital, Hamilton Health Sciences ‡Department of Radiation Oncology, Juravinski Cancer Centre, Hamilton Health Sciences #Department of Pediatrics, Division of Hematology-Oncology, McMaster University, Hamilton †Department of Child Health Evaluative Services, Hospital for Sick Children ¶Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto ∥Health Utilities Inc., Dundas, ON, Canada.
authors.forename: JoAnn
authors.initials: J
authors.lastname: Duckworth
authors.forename: Trishana
authors.initials: T
authors.lastname: Nayiager
authors.forename: Eleanor
authors.initials: E
authors.lastname: Pullenayegum
authors.forename: Anthony
authors.initials: A
authors.lastname: Whitton
authors.forename: Robert
authors.initials: R
authors.lastname: Hollenberg
authors.forename: John
authors.initials: J
authors.lastname: Horsman
authors.forename: William
authors.initials: W
authors.lastname: Furlong
authors.forename: Rachel
authors.initials: R
authors.lastname: Spitzer
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Barr
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001932:Brain Neoplasms / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D006304:Health Status; D006801:Humans; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*; D013995:Time