Gurney James G, Tersak Jean M, Ness Kirsten K, Landier Wendy, Matthay Katherine K, Schmidt Mary Lou
Department of Pediatrics, University of Michigan, 300 N Ingalls St, Room 6E02, Ann Arbor, MI 48109, USA.
Pediatrics. 2007 Nov;120(5):e1229-36. doi: 10.1542/peds.2007-0178.
Among a cohort of long-term neuroblastoma survivors, our aims were to (1) assess the association between treatment intensity and parent-reported hearing loss in the child, (2) evaluate the strength of the association between hearing loss and parent-reported academic and psychosocial difficulties in the child, and (3) examine the association between parent-reported academic and psychosocial difficulties in the child and the child's self-reported quality of life.
Through a mailed survey that included the Pediatric Quality of Life Inventory 4.0 and an outcomes questionnaire for parents, we evaluated 137 children (aged 8-17 years) who were previously enrolled in 1 of 2 Children's Cancer Group neuroblastoma clinical studies.
Childhood survivors of neuroblastoma who had prevalent hearing loss, as reported by their parents, had at least twice the risk of an identified problem with reading skills, math skills, and/or attention and a similarly higher risk of a general learning disability and/or special educational needs than did neuroblastoma survivors without hearing loss. Consistent with this finding, hearing loss was associated with a 10-point-lower mean score in the school-functioning scale of the Pediatric Quality of Life Inventory 4.0. We also observed a clear pattern of poorer self-reported quality-of-life scores among children with parent-reported academic and psychosocial problems compared with those without such problems, particularly with school functioning, even after controlling for reported hearing loss.
We found evidence that long-term neuroblastoma survivors, especially those with hearing loss, are at elevated risk for academic learning problems and psychosocial difficulties. We also found strong concordance between parent-reported learning problems in the child and indications of distress in the child's self-reported quality of life.
在一组长期神经母细胞瘤幸存者中，我们的目标是：（1）评估治疗强度与家长报告的孩子听力损失之间的关联；（2）评估听力损失与家长报告的孩子学业及心理社会困难之间关联的强度；（3）研究家长报告的孩子学业及心理社会困难与孩子自我报告的生活质量之间的关联。
通过一项邮寄调查，其中包括儿童生活质量量表4.0和家长用的结果问卷，我们评估了137名儿童（年龄8 - 17岁），这些儿童先前参加了儿童癌症组两项神经母细胞瘤临床研究中的一项。
据家长报告有听力损失的神经母细胞瘤儿童幸存者，出现阅读技能、数学技能和/或注意力问题的风险至少是无听力损失的神经母细胞瘤幸存者的两倍，出现一般学习障碍和/或特殊教育需求的风险同样更高。与这一发现一致，在儿童生活质量量表4.0的学校功能量表中，听力损失与平均得分低10分相关。我们还观察到，与没有此类问题的儿童相比，有家长报告的学业和心理社会问题的儿童自我报告的生活质量得分明显更低，尤其是在学校功能方面，即使在控制了报告的听力损失之后也是如此。
我们发现有证据表明，长期神经母细胞瘤幸存者，尤其是那些有听力损失的幸存者，出现学业学习问题和心理社会困难的风险更高。我们还发现，家长报告的孩子学习问题与孩子自我报告的生活质量中的苦恼迹象之间有很强的一致性。
