Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Pediatr Blood Cancer. 2021 Aug;68(8):e29130. doi: 10.1002/pbc.29130. Epub 2021 May 27.
Brain tumor survivors are at risk for significant late effects following treatment completion that may adversely impact health-related quality of life (HRQOL). The current study examines the relationship between executive functioning (EF) and HRQOL in pediatric brain tumor survivors within a longitudinal framework. We hypothesized that early deficits in EF would be related to less optimal HRQOL in this population.
The current study utilized retrospective medical chart review to identify neurocognitive correlates of HRQOL in 137 youth previously treated for a pediatric brain tumor. Participants completed the Pediatric Quality of Life Inventory (PedsQL) and neuropsychological assessment, including a well-validated measure of executive functioning (Behavior Rating Inventory of Executive Function; BRIEF). General linear regression and multivariate models were utilized to examine the relationship between child executive functioning and HRQOL.
Multiple domains of child executive functioning, as reported by parents on the BRIEF, significantly predicted parent-proxy reported HRQOL after controlling for demographic and medical covariates, including child intellectual functioning (IF). Similarly, after controlling for covariates, the BRIEF Cognitive Regulation Index was a significant predictor of self-reported physical and school functioning domains of HRQOL.
Current data demonstrate EF is a significant predictor of HRQOL during survivorship for youth previously diagnosed with a pediatric brain tumor. Results suggest that opportunities may exist to intervene and improve HRQOL of pediatric brain tumor survivors by targeting EF.
脑肿瘤幸存者在治疗完成后存在显著的晚期效应风险，这可能对健康相关生活质量（HRQOL）产生不利影响。本研究在纵向框架内考察了儿童脑肿瘤幸存者的执行功能（EF）与 HRQOL 之间的关系。我们假设 EF 的早期缺陷与该人群的 HRQOL 不太理想有关。
本研究利用回顾性病历审查，确定了 137 名以前接受过儿童脑肿瘤治疗的青少年的 HRQOL 的神经认知相关性。参与者完成了儿科生活质量量表（PedsQL）和神经心理学评估，包括一个经过充分验证的执行功能测量工具（行为评定量表的执行功能；BRIEF）。采用一般线性回归和多元模型来检验儿童执行功能与 HRQOL 之间的关系。
BRIEF 报告的儿童执行功能的多个领域，在控制人口统计学和医疗协变量（包括儿童智力功能（IF））后，显著预测了父母报告的 HRQOL。同样，在控制协变量后，BRIEF 认知调节指数是 HRQOL 的自我报告身体和学校功能领域的显著预测指标。
目前的数据表明，EF 是儿童脑肿瘤幸存者生存期间 HRQOL 的重要预测指标。结果表明，通过针对 EF，可能有机会干预和改善儿童脑肿瘤幸存者的 HRQOL。
