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Neuropsychological and socioeconomic outcomes in adult survivors of pediatric low-grade glioma.
Cancer 2019; 125(17):3050-3058C

Abstract

BACKGROUND

Current estimates suggest that 75% of children diagnosed with a central nervous system (CNS) tumor will become 5-year survivors. However, survivors of childhood CNS tumors are at increased risk for long-term morbidity.

METHODS

To determine long-term neuropsychological and socioeconomic status (SES) outcomes, adult survivors of pediatric low-grade gliomas (n = 181) in the Childhood Cancer Survivor Study and a sibling comparison group that was frequency-matched by age and sex (n = 105) completed a comprehensive battery of standardized neuropsychological tests and an SES assessment. Multivariable regression models compared treatment-specific groups for neuropsychological and SES outcomes and evaluated associations with tumor location, age at diagnosis, sex, and age at evaluation.

RESULTS

In adjusted models, survivors treated with surgery and radiotherapy (surgery+RT; median age at diagnosis, 7 years; median age at assessment, 41 years) scored lower on estimated IQ than survivors treated with surgery only, who scored lower than siblings (surgery+RT, 93.9; surgery only, 101.2; siblings, 108.5; all P values <.0001). Survivors diagnosed at younger ages had low scores for all outcomes (P < .05) except for attention/processing speed. For SES outcomes, survivors treated with surgery+RT had lower occupation scores (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.1-5.9), lower income (OR, 2.6; 95% CI, 1.3-5.0), and less education (OR, 2.1; 95% CI, 1.1-4.0) than those treated with surgery only.

CONCLUSIONS

Decades after treatment, survivors treated with radiotherapy and at younger ages had poorer neuropsychological and SES outcomes. Lifelong surveillance of survivors of pediatric low-grade gliomas may be warranted as life events, stages, and transitions (employment, family, and aging) present new challenges and risks.

Authors+Show Affiliations

Department of Pediatrics, Baylor College of Medicine, Houston, Texas. Texas Children's Hospital, Houston, Texas.Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.Department of Human Development and Family Studies, Penn State University, University Park, Pennsylvania.Department of Pediatrics, Baylor College of Medicine, Houston, Texas. Texas Children's Hospital, Houston, Texas.Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31231797

Citation

Ris, M Douglas, et al. "Neuropsychological and Socioeconomic Outcomes in Adult Survivors of Pediatric Low-grade Glioma." Cancer, vol. 125, no. 17, 2019, pp. 3050-3058.
Ris MD, Leisenring WM, Goodman P, et al. Neuropsychological and socioeconomic outcomes in adult survivors of pediatric low-grade glioma. Cancer. 2019;125(17):3050-3058.
Ris, M. D., Leisenring, W. M., Goodman, P., Di, C., Noll, J., Levy, W., ... Armstrong, G. T. (2019). Neuropsychological and socioeconomic outcomes in adult survivors of pediatric low-grade glioma. Cancer, 125(17), pp. 3050-3058. doi:10.1002/cncr.32186.
Ris MD, et al. Neuropsychological and Socioeconomic Outcomes in Adult Survivors of Pediatric Low-grade Glioma. Cancer. 2019 Sep 1;125(17):3050-3058. PubMed PMID: 31231797.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neuropsychological and socioeconomic outcomes in adult survivors of pediatric low-grade glioma. AU - Ris,M Douglas, AU - Leisenring,Wendy M, AU - Goodman,Pamela, AU - Di,Chongzhi, AU - Noll,Jennie, AU - Levy,Wendy, AU - Robison,Leslie L, AU - Armstrong,Gregory T, Y1 - 2019/06/24/ PY - 2019/01/17/received PY - 2019/04/03/revised PY - 2019/04/20/accepted PY - 2020/09/01/pmc-release PY - 2019/6/25/pubmed PY - 2019/6/25/medline PY - 2019/6/25/entrez KW - brain tumors KW - childhood astrocytoma KW - neuropsychological SP - 3050 EP - 3058 JF - Cancer JO - Cancer VL - 125 IS - 17 N2 - BACKGROUND: Current estimates suggest that 75% of children diagnosed with a central nervous system (CNS) tumor will become 5-year survivors. However, survivors of childhood CNS tumors are at increased risk for long-term morbidity. METHODS: To determine long-term neuropsychological and socioeconomic status (SES) outcomes, adult survivors of pediatric low-grade gliomas (n = 181) in the Childhood Cancer Survivor Study and a sibling comparison group that was frequency-matched by age and sex (n = 105) completed a comprehensive battery of standardized neuropsychological tests and an SES assessment. Multivariable regression models compared treatment-specific groups for neuropsychological and SES outcomes and evaluated associations with tumor location, age at diagnosis, sex, and age at evaluation. RESULTS: In adjusted models, survivors treated with surgery and radiotherapy (surgery+RT; median age at diagnosis, 7 years; median age at assessment, 41 years) scored lower on estimated IQ than survivors treated with surgery only, who scored lower than siblings (surgery+RT, 93.9; surgery only, 101.2; siblings, 108.5; all P values <.0001). Survivors diagnosed at younger ages had low scores for all outcomes (P < .05) except for attention/processing speed. For SES outcomes, survivors treated with surgery+RT had lower occupation scores (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.1-5.9), lower income (OR, 2.6; 95% CI, 1.3-5.0), and less education (OR, 2.1; 95% CI, 1.1-4.0) than those treated with surgery only. CONCLUSIONS: Decades after treatment, survivors treated with radiotherapy and at younger ages had poorer neuropsychological and SES outcomes. Lifelong surveillance of survivors of pediatric low-grade gliomas may be warranted as life events, stages, and transitions (employment, family, and aging) present new challenges and risks. SN - 1097-0142 UR - https://www.unboundmedicine.com/medline/citation/31231797/Neuropsychological_and_socioeconomic_outcomes_in_adult_survivors_of_pediatric_low-grade_glioma L2 - https://doi.org/10.1002/cncr.32186 DB - PRIME DP - Unbound Medicine ER -