Glaser A W, Abdul Rashid N F, U C L, Walker D A
Department of Child Health, University of Nottingham, Queens Medical Centre, UK.
Br J Cancer. 1997;76(5):643-50. doi: 10.1038/bjc.1997.439.
This study was designed to assess the overall morbidity burden of survival from central nervous system (CNS) tumours and its impact on return to a normal lifestyle. School behaviour and health status of 27 children after treatment for CNS tumours, of 25 of their school-aged siblings, plus age- and sex-matched controls is reported. Spinetta school behaviour, Lansky play-performance and Health Utilities Index (mark II and III) assessments have been made. Patients had reduced mobility and increased pain levels. They demonstrated a reluctance to participate in organized physical activities. Impaired cognition, emotion and self-esteem were reported. They worried more than controls but attended school willingly, interacted normally with their peers and viewed the future confidently. Their siblings were reluctant to express openly concern for others or feelings of joy. Teachers were reliable proxies for most attributes, notable exceptions being speech and emotion. This is the first study to have assessed the school behaviour of a cohort solely composed of survivors of childhood CNS tumours. The good social reintegration is reassuring and likely to reflect a high level of psychosocial support. However, the results presented identify these young people as a 'special educational needs' group as defined by the 1981 and 1993 Education Acts.
本研究旨在评估中枢神经系统（CNS）肿瘤幸存者的总体发病负担及其对恢复正常生活方式的影响。报告了27名接受CNS肿瘤治疗后的儿童、25名学龄期同胞兄弟姐妹以及年龄和性别匹配的对照组的学校行为和健康状况。进行了斯皮内塔学校行为、兰斯基游戏表现和健康效用指数（第二版和第三版）评估。患者活动能力下降，疼痛程度增加。他们表现出不愿参加有组织的体育活动。据报告存在认知、情感和自尊受损的情况。他们比对照组更焦虑，但愿意上学，与同龄人正常互动，并对未来充满信心。他们的兄弟姐妹不愿公开表达对他人的关心或喜悦之情。对于大多数特征，教师是可靠的代理人，但言语和情感方面明显例外。这是第一项评估仅由儿童CNS肿瘤幸存者组成的队列的学校行为的研究。良好的社会重新融入令人放心，可能反映了高水平的心理社会支持。然而，所呈现的结果将这些年轻人确定为1981年和1993年《教育法》所定义的“特殊教育需求”群体。
