Health-Related Quality of Life and Cognitive Functioning at On- and Off-Treatment Periods in Children Aged between 6-13 Years Old with Brain Tumors: A Prospective Longitudinal Study

Abstract

PurposeOur study aimed to examine the relationship between intelligence and health-related quality of life (HRQOL) in children (6-13 years old) diagnosed as having a brain tumor.Materials and MethodsWe administered a Korean version of the Wechsler Intelligence Scale for Children-III, the Pediatric Quality of Life Inventory, version 4.0 (PedsQL), the Korean version of the Parenting Stress Index-Short Form, and the Korean Version of the Parenting Sense of Competence (K-PSOC) scale before or after initial radiotherapy (T1) and after treatment termination (T2). In total, 13 patients completed both the T1 and T2 interviews.ResultsScores significantly declined between T1 and T2 on the full-scale intelligence quotients (FIQ), verbal intelligence quotients (VIQ), performance intelligence quotients (PIQ), similarity and coding tests, as well as the K-PSOC, which measures parental anxiety. FIQ scores at T1 were correlated with the self-reported PedsQL total scores (r=0.739) and the parent proxy-report PedsQL scores for school functioning (r=0.706) at T2. Also, the FIQ scores at T2 were correlated with the self-reported PedsQL total scores (r=0.748) and scores for physical health (r=0.728) at T2.ConclusionThe cognitive ability and intelligence level of the patients significantly declined between on and off treatment periods, and higher intelligence functioning at both on and off treatment was correlated with long-term higher HRQOL. Further investigations that monitor intelligence, HRQOL and parenting stress over a longer period, using a greater number of participants, are needed.

Patient-reported health status during pediatric cancer treatment

“…Children in induction therapy for ALL have worse physical functioning than population norms by proxy report . Children with brain tumors receiving radiation therapy have profound limitations in physical functioning . Our study confirms previous findings and expands our understanding of limitations to physical functioning by characterizing the changes in physical functioning over 6 months of cancer treatment in a broad patient population using a robust PRO measure.…”

“…Variables of interest that impact PROs or have the potential to impact them were collected, including tumor type (leukemia/lymphoma, solid tumor, CNS tumor) and intensity of treatment . The Intensity of Treatment Rating Scale 3 (ITR‐3) was used to classify treatment into moderately, very, or most intensive groups .…”

“…As we pursue aggressive therapies to achieve greater survival, increasing attention is paid to the impact of cancer on patients’ lives. Children with cancer experience symptoms related to physical health (e.g., pain, fatigue, decreased ability to be physically active), social health (e.g., fewer interactions with peers), and emotional distress (e.g., anxiety and depression) as a result of the disease and its treatment . Despite awareness of these experiences among cancer clinicians, limitations in understanding the true impact of the cancer experience on patients’ lives leads to suboptimal use of supportive care interventions and resources …”

“…PRO use in children with cancer broadly demonstrated the impact of the cancer experience on physical, emotional, and social health . Cross‐sectional studies established that children with cancer experience worse physical health due to symptoms such as fatigue and limitations in physical activity, and that emotional distress is common . Additional patient factors, such as female gender and older age, appear to be associated with worse physical and emotional health .…”

Emotional and Behavioral Functioning After Conformal Radiation Therapy for Pediatric Ependymoma

“…Completed studies have limitations reducing their results’ generalizability, including small sample sizes [16,17], focusing only on a short time period [18], or having few observations [16,17]. Moreover, few researchers have completed serial assessments with patients from diagnosis into the off-treatment period, limiting our understanding of the trajectory of emotional and behavioral functioning over time.…”