Long-term neurologic health and psychosocial function of adult survivors of childhood medulloblastoma/PNET: A report from the Childhood Cancer Survivor Study Journal Article
| Authors: | King, A. A.; Seidel, K.; Di, C.; Leisenring, W. M.; Perkins, S. M.; Krull, K. R.; Sklar, C. A.; Green, D. M.; Armstrong, G. T.; Zeltzer, L. K.; Wells, E.; Stovall, M.; Ullrich, N. J.; Oeffinger, K. C.; Robison, L. L.; Packer, R. J. |
| Article Title: | Long-term neurologic health and psychosocial function of adult survivors of childhood medulloblastoma/PNET: A report from the Childhood Cancer Survivor Study |
| Abstract: | Background. Medulloblastoma is the most common malignant childhood brain tumor, although long-term risks for chronic neurologic health and psychosocial functioning in aging adult survivors are incompletely characterized. Methods. The Childhood Cancer Survivor Study (CCSS) includes 380 fve-year survivors of medulloblastoma/primitive neuroectodermal tumor (PNET; median age at follow-up: 30 y, interquartile range 24-36) and sibling comparison (n = 4031). Cumulative incidence of neurologic health conditions was reported. Cox regression models provided hazard ratios (HRs) and 95% CIs. Cross-sectional outcomes were assessed using generalized linear models. Results. Compared with siblings, survivors were at increased risk of late-onset hearing loss (HR: 36.0, 95% CI: 23.6-54.9), stroke (HR: 33.9, 95% CI: 17.8-64.7), seizure (HR: 12.8, 95% CI: 9.0-18.1), poor balance (HR: 10.4, 95% CI: 6.7-15.9), tinnitus (HR: 4.8, 95% CI: 3.5-6.8), and cataracts (HR: 31.8, 95% CI: 16.7-60.5). Temporal/frontal lobe radiotherapy of 50 Gy or more increased risk for hearing loss (HR: 1.9, 95% CI: 1.1-1.3), seizure (HR: 2.1, 95% CI: 1.1-3.9), stroke (HR: 3.5, 95% CI: 1.3-9.1), and tinnitus (HR: 2.0, 95% CI: 1.0-3.9). Survivors were less likely than siblings to earn a college degree (relative risk [RR]: 0.49, 95% CI: 0.39-0.60), marry (RR: 0.35, 95% CI: 0.29-0.42), and live independently (RR: 0.58, 95% CI: 0.52-0.66). Conclusions. Adult survivors of childhood medulloblastoma/PNET demonstrate pronounced risk for hearing impairment, stroke, lower educational attainment, and social independence. Interventions to support survivors should be a high priority. © 2017 The Author. |
| Keywords: | late effects; medulloblastoma; psychosocial outcomes; neurologic outcomes |
| Journal Title: | Neuro-Oncology |
| Volume: | 19 |
| Issue: | 5 |
| ISSN: | 1522-8517 |
| Publisher: | Oxford University Press |
| Date Published: | 2017-05-01 |
| Start Page: | 689 |
| End Page: | 698 |
| Language: | English |
| DOI: | 10.1093/neuonc/now242 |
| PROVIDER: | scopus |
| PUBMED: | 28039368 |
| PMCID: | PMC5464442 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 June 2017 -- Source: Scopus |
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