Current situation of central nervous system tumour survivors in a spanish hospital

Introduction: Despite the increasing number of central nervous system (CNS) tumour survivors, long-term (LT) sequelae remain a substantial burden on their health through various life stages. The aim of our study was to evaluate late morbidity, health-related quality of life (HRQoL), self-esteem, functional status, adaptive behaviour, physical activity and social outcomes such as education, employment, relationship status and possession of a driver's license, in addition to the role of LT effects of radiotherapy (RTx) on these outcomes.

Methods: The study included 111 CNS tumour survivors with a minimum of 10 years of follow-up. The assessment of patients included a comprehensive clinical evaluation and psychological questionnaires: SF-36 for HRQoL and Rosenberg self-esteem scale. Functional status was assessed with the Lansky/Karnosky scales and adaptive behaviour with the Vineland-II scale. Patients also completed one questionnaire that assessed physical activity and another that assessed other social variables.

Results: The mean current age of CNS tumour survivors was 20 years (range, 12-34). The median time since diagnosis was 13 years (range, 10-26). The median age at diagnosis was 6 years (range, 1-18). The most prevalent LT sequelae were neurologic (55%), followed by neuropsychiatric (53.1%) and endocrine (49.5%) sequelae. Survivors treated with RTx (n = 52) had poorer outcomes in terms of adaptive behaviour, educational attainment and relationship status compared to those who did not receive RTx, but we did not find differences in quality of life or self-esteem scores between these groups.

Conclusion: We found a high prevalence of long-term sequelae in CNS tumour survivors, especially in those who received RTx. In these patients, LT sequelae have a significant impact on functional status and social outcomes, but not on quality of life or self-esteem.