Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Department of Psychology, The University of Memphis, Memphis, Tennessee, USA.
Psychooncology. 2022 May;31(5):779-787. doi: 10.1002/pon.5862. Epub 2021 Dec 2.
Youth with craniopharyngioma experience weight gain, fragmented sleep, excessive daytime sleepiness (EDS), fatigue, and psychosocial problems that negatively impact their overall health-related quality of life (HRQoL). Greater hypothalamic tumor involvement (HI) may be associated with higher rates or severity of these impairments; however, the direct and indirect impact of HI on the physical and psychosocial consequences associated with pediatric craniopharyngioma remain unclear. The purpose of the current study was to examine relations between HI, body mass index (BMI), fragmented sleep, EDS, fatigue, psychosocial problems, and HRQoL among youth with craniopharyngioma.
Eighty-four youth with craniopharyngioma (M = 10.27 ± 4.3 years, 53.6% female, 64.3% White) were assessed with actigraphy, nocturnal polysomnography, and multiple sleep latency tests prior to proton therapy, when indicated. Caregivers completed measures of fatigue, psychosocial functioning, and HRQoL.
Hypothalamic tumor involvement was associated with greater BMI (Est. = 2.97, p = 0.003) and daytime sleepiness (Est. = 2.53, p = 0.01). Greater fatigue predicted more psychosocial problems (Est. = 0.29, p < 0.001) and lower HRQoL (Est. = 0.23, p = 0.001). Psychosocial problems also predicted lower HRQoL (Est. = -0.34, p = 0.004). Fragmented sleep (Est. = 0.03, p = 0.04) and fatigue (Est. = 0.10, p = 0.02) indirectly predicted lower HRQoL through psychosocial problems.
Youth with craniopharyngioma with greater HI may benefit from weight reduction interventions and management of excessive sleepiness. Patients should be prospectively monitored for sleep problems, fatigue, and psychosocial problems, as these patients may benefit from interventions targeting fatigue and psychosocial health to improve HRQoL.
颅咽管瘤患儿会出现体重增加、睡眠片段化、日间嗜睡（EDS）、疲劳和心理社会问题，这些问题对他们的整体健康相关生活质量（HRQoL）产生负面影响。下丘脑肿瘤受累（HI）程度更高可能与这些损伤的发生率或严重程度更高有关；然而，HI 对与小儿颅咽管瘤相关的身体和心理社会后果的直接和间接影响仍不清楚。本研究的目的是检查 HI、体重指数（BMI）、睡眠片段化、EDS、疲劳、心理社会问题与颅咽管瘤患儿 HRQoL 之间的关系。
84 名颅咽管瘤患儿（M=10.27±4.3 岁，53.6%为女性，64.3%为白人）在质子治疗前（当需要时）接受了活动记录仪、夜间多导睡眠图和多次睡眠潜伏期测试。照顾者完成了疲劳、心理社会功能和 HRQoL 的测量。
下丘脑肿瘤受累与 BMI 更大（Est.=2.97，p=0.003）和日间嗜睡（Est.=2.53，p=0.01）有关。更大的疲劳预示着更多的心理社会问题（Est.=0.29，p<0.001）和更低的 HRQoL（Est.=0.23，p=0.001）。心理社会问题也预示着更低的 HRQoL（Est.=-0.34，p=0.004）。睡眠片段化（Est.=0.03，p=0.04）和疲劳（Est.=0.10，p=0.02）通过心理社会问题间接预测更低的 HRQoL。
下丘脑肿瘤受累程度较大的颅咽管瘤患儿可能受益于减重干预和过度嗜睡的管理。应前瞻性监测这些患者的睡眠问题、疲劳和心理社会问题，因为这些患者可能受益于针对疲劳和心理健康的干预措施，以提高 HRQoL。
