Long-term sequelae in children treated for brain tumors: impairments, disability, and handicap

Pediatr Hematol Oncol. 2003 Mar;20(2):89-101. doi: 10.1080/0880010390158595.

Abstract

Sixty-one long-term survivors, treated for brain tumors in childhood, were evaluated in term of neurological impairments, disability, and handicap. Thirty-eight patients (pts) (62%) had at least one impairment. Visual impairment was detected in 14 pts (24%), associated with recurrence (p = .012). Thirty-four patients (56%) had motor impairment, associated with sex (female) in irradiated patients; 13 (21%) had epilepsy, associated with supratentorial tumor site (p = .001). The same number of patients had brain atrophy; risk factors were hydrocephalus at diagnosis and perioperative complications. Sixteen patients (30%) had IQ score < 80, associated with young age at first treatment (p = .006) and recurrence (p = .043). Twenty-seven out of 61 of our patients (44%) were disabled: 12 mildly, 14 moderately, and 1 severely. Epilepsy was the most important risk factor for disability. Cognitive impairment, motor impairment, and epilepsy were associated with employment (43%); cognitive impairment was also associated with education.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Atrophy
  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain / radiation effects
  • Brain Damage, Chronic / epidemiology
  • Brain Damage, Chronic / etiology*
  • Brain Neoplasms / complications
  • Brain Neoplasms / drug therapy
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / surgery
  • Brain Neoplasms / therapy*
  • Calcinosis / epidemiology
  • Calcinosis / etiology
  • Child
  • Child, Preschool
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects
  • Combined Modality Therapy
  • Cranial Irradiation / adverse effects
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / adverse effects
  • Disabled Children / psychology
  • Epilepsy / epidemiology
  • Epilepsy / etiology
  • Etoposide / administration & dosage
  • Etoposide / adverse effects
  • Female
  • Humans
  • Hydrocephalus / epidemiology
  • Hydrocephalus / etiology
  • Infant
  • Intellectual Disability / epidemiology
  • Intellectual Disability / etiology
  • Learning Disabilities / epidemiology
  • Learning Disabilities / etiology
  • Lomustine / administration & dosage
  • Lomustine / adverse effects
  • Magnetic Resonance Imaging
  • Male
  • Methotrexate / administration & dosage
  • Methotrexate / adverse effects
  • Movement Disorders / epidemiology
  • Movement Disorders / etiology
  • Neoplasm Recurrence, Local
  • Prevalence
  • Procarbazine / administration & dosage
  • Procarbazine / adverse effects
  • Radiation Injuries / epidemiology
  • Radiation Injuries / etiology
  • Slovenia / epidemiology
  • Survivors* / psychology
  • Tomography, X-Ray Computed
  • Unemployment / statistics & numerical data
  • Vincristine / administration & dosage
  • Vincristine / adverse effects
  • Vision Disorders / epidemiology
  • Vision Disorders / etiology

Substances

  • Procarbazine
  • Vincristine
  • Etoposide
  • Lomustine
  • Cyclophosphamide
  • Cisplatin
  • Methotrexate