Helligsoe Anne Sophie L, Henriksen Louise T, Kenborg Line, Lassen-Ramshad Yasmin, Wu Lisa M, Winther Jeanette F, Hasle Henrik, Amidi Ali
Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
Department of Clinical Medicine, Faculty of Health, Aarhus University, Denmark.
Neurooncol Pract. 2022 Oct 25;10(2):140-151. doi: 10.1093/nop/npac085. eCollection 2023 Apr.
Childhood brain tumor survivors are at high risk of late effects, especially neurocognitive impairment. Limited data are available examining neurocognitive function and associations with quality of life (QoL) in childhood brain tumor survivors. Our aim was to examine neurocognitive function in childhood brain tumor survivors, and associations with QoL and symptom burden.
Five-year survivors of brain tumors over the age of 15 were identified in the Danish Childhood Cancer Registry ( = 423). Eligible and consenting participants completed neuropsychological tests and questionnaires assessing QoL, insomnia, fatigue, anxiety, and depression. Survivors treated with radiation ( = 59) were statistically compared with survivors not treated with radiation ( = 102).
In total, 170 survivors participated (40.2% participation rate). Sixty-six percent of the survivors who completed neurocognitive tests ( = 161) exhibited overall neurocognitive impairment. Survivors treated with radiation, especially whole-brain irradiation, exhibited poorer neurocognitive outcomes than survivors not treated with radiation. Neurocognitive outcomes for survivors treated with surgery were below normative expectations. Furthermore, a number of survivors experienced significant fatigue (40%), anxiety (23%), insomnia (13%), and/or depression (6%). Survivors treated with radiation reported lower quality of life (QoL) and higher symptom burden scores than survivors not treated with radiation; particularly in physical functioning, and social functioning with symptoms of fatigue. Neurocognitive impairment was not associated with QoL or symptom burden.
In this study, a majority of the childhood brain tumor survivors experienced neurocognitive impairment, reduced QoL, and high symptom burden. Although not associated with each other, it is apparent that childhood brain tumor survivors experience not only neurocognitive dysfunction but may also experience QoL impairments and significant symptom burden.
儿童脑肿瘤幸存者面临着较高的迟发效应风险，尤其是神经认知障碍。关于儿童脑肿瘤幸存者神经认知功能及其与生活质量（QoL）的关联的数据有限。我们的目的是研究儿童脑肿瘤幸存者的神经认知功能，以及其与生活质量和症状负担的关联。
在丹麦儿童癌症登记处识别出年龄超过15岁的脑肿瘤五年幸存者（n = 423）。符合条件并同意参与的参与者完成了神经心理学测试以及评估生活质量、失眠、疲劳、焦虑和抑郁的问卷。对接受放疗的幸存者（n = 59）与未接受放疗的幸存者（n = 102）进行了统计学比较。
共有170名幸存者参与（参与率为40.2%）。完成神经认知测试的幸存者中（n = 161），66%表现出整体神经认知障碍。接受放疗的幸存者，尤其是全脑照射的幸存者，其神经认知结果比未接受放疗的幸存者更差。接受手术治疗的幸存者的神经认知结果低于正常预期。此外，许多幸存者经历了严重的疲劳（40%）、焦虑（23%）、失眠（13%）和/或抑郁（6%）。接受放疗的幸存者报告的生活质量（QoL）较低，症状负担得分高于未接受放疗的幸存者；特别是在身体功能以及伴有疲劳症状的社会功能方面。神经认知障碍与生活质量或症状负担无关。
在本研究中，大多数儿童脑肿瘤幸存者经历了神经认知障碍、生活质量下降和高症状负担。虽然它们之间没有关联，但很明显儿童脑肿瘤幸存者不仅经历神经认知功能障碍，还可能经历生活质量受损和严重的症状负担。
