Mann-Markutzyk Laura Verena, Beckhaus Julia, Özyurt Jale, Mehren Aylin, Friedrich Carsten, Müller Hermann L
Department of Pediatrics and Pediatric Hematology/Oncology, University Children's Hospital, Carl von Ossietzky Universität Oldenburg, Klinikum Oldenburg AöR, Rahel-Straus-Strasse 10, 26133, Oldenburg, Germany.
Biological Psychology Lab, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg School IV, Oldenburg, Germany.
Sci Rep. 2025 Mar 19;15(1):9407. doi: 10.1038/s41598-025-94384-5.
Overall survival rates after craniopharyngioma (CP) are high (92%), but frequently quality of life (QoL) is impaired in patients with CP involving hypothalamic structures. Tumour- and/or treatment-related hypothalamic lesions may result in disturbances of circadian rhythms including increased daytime sleepiness. We investigated the relationship between health-related QoL and daytime sleepiness in patients with childhood-onset CP. After a median follow-up of 10 years (range: 1-39), 119 CP patients (63 female), who were recruited 2000-2022 in the KRANIOPHARYNGEOM 2000/2007 and KRANIOPHARYNGEOM Registry 2019 trials, were assessed for daytime sleepiness using the Epworth Sleepiness Scale (ESS) and for QoL by EORTC QLQ-C30 questionnaire. CP patients with increased daytime sleepiness (ESS score > 10, n = 34) had worse self-assessment of QoL (p = 0.003), when compared to CP patients with normal ESS scores (n = 85). Increased daytime sleepiness was negatively correlated with QoL (r=-0.395; p < 0.001). Surgical hypothalamic lesions, detectable after surgical intervention in 92.9% of the reference-assessed patients, were associated with significantly higher ESS scores, whereas such impact could not be observed for presurgical hypothalamic involvement of the CP (72.4% of the reference-assessed patients). Compared to patients with an ESS score in the normal range, patients with increased daytime sleepiness suffered from impaired QoL in all functional scales and the global QoL scale of the EORTC QLQ-C30. As increased daytime sleepiness plays an important role for QoL in survivors of CP, hypothalamus-sparing surgical treatment strategies should be considered as state of the art in patients with CP for prevention of increased daytime sleepiness.Clinical trial registration NCT01272622; NCT04158284, NCT00258453.
颅咽管瘤（CP）患者的总体生存率较高（92%），但涉及下丘脑结构的CP患者的生活质量（QoL）常常受损。肿瘤和/或治疗相关的下丘脑病变可能导致昼夜节律紊乱，包括日间嗜睡增加。我们研究了儿童期起病的CP患者健康相关生活质量与日间嗜睡之间的关系。在KRANIOPHARYNGEOM 2000/2007和KRANIOPHARYNGEOM注册研究2019试验中，于2000年至2022年招募的119例CP患者（63例女性），在中位随访10年（范围：1 - 39年）后，使用爱泼沃斯嗜睡量表（ESS）评估日间嗜睡情况，并通过欧洲癌症研究与治疗组织QLQ - C30问卷评估生活质量。与ESS评分正常的CP患者（n = 85）相比，日间嗜睡增加（ESS评分>10，n = 34）的CP患者对生活质量的自我评估更差（p = 0.003）。日间嗜睡增加与生活质量呈负相关（r = -0.395；p < 0.001）。在92.9%的参考评估患者中，手术干预后可检测到的手术性下丘脑病变与显著更高的ESS评分相关，而术前CP的下丘脑受累情况（72.4%的参考评估患者）则未观察到这种影响。与ESS评分在正常范围内的患者相比，日间嗜睡增加的患者在欧洲癌症研究与治疗组织QLQ - C30的所有功能量表和总体生活质量量表中生活质量均受损。由于日间嗜睡增加对CP幸存者的生活质量起着重要作用，对于CP患者，应考虑采用保留下丘脑的手术治疗策略作为预防日间嗜睡增加的最佳治疗方法。临床试验注册号：NCT01272622；NCT04158284，NCT00258453。
