Neuropsychological and socioeconomic outcomes in adult survivors of pediatric low-grade glioma

M. Douglas Ris, Wendy M. Leisenring, Pamela Goodman, Chongzhi Di, Jennie Noll, Wendy Levy, Leslie L. Robison, Gregory T. Armstrong

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Abstract

Background: Current estimates suggest that 75% of children diagnosed with a central nervous system (CNS) tumor will become 5-year survivors. However, survivors of childhood CNS tumors are at increased risk for long-term morbidity. Methods: To determine long-term neuropsychological and socioeconomic status (SES) outcomes, adult survivors of pediatric low-grade gliomas (n = 181) in the Childhood Cancer Survivor Study and a sibling comparison group that was frequency-matched by age and sex (n = 105) completed a comprehensive battery of standardized neuropsychological tests and an SES assessment. Multivariable regression models compared treatment-specific groups for neuropsychological and SES outcomes and evaluated associations with tumor location, age at diagnosis, sex, and age at evaluation. Results: In adjusted models, survivors treated with surgery and radiotherapy (surgery+RT; median age at diagnosis, 7 years; median age at assessment, 41 years) scored lower on estimated IQ than survivors treated with surgery only, who scored lower than siblings (surgery+RT, 93.9; surgery only, 101.2; siblings, 108.5; all P values <.0001). Survivors diagnosed at younger ages had low scores for all outcomes (P <.05) except for attention/processing speed. For SES outcomes, survivors treated with surgery+RT had lower occupation scores (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.1-5.9), lower income (OR, 2.6; 95% CI, 1.3-5.0), and less education (OR, 2.1; 95% CI, 1.1-4.0) than those treated with surgery only. Conclusions: Decades after treatment, survivors treated with radiotherapy and at younger ages had poorer neuropsychological and SES outcomes. Lifelong surveillance of survivors of pediatric low-grade gliomas may be warranted as life events, stages, and transitions (employment, family, and aging) present new challenges and risks.

Original languageEnglish (US)
Pages (from-to)3050-3058
Number of pages9
JournalCancer
Volume125
Issue number17
DOIs
StatePublished - Jan 1 2019

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All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Ris, M. D., Leisenring, W. M., Goodman, P., Di, C., Noll, J., Levy, W., Robison, L. L., & Armstrong, G. T. (2019). Neuropsychological and socioeconomic outcomes in adult survivors of pediatric low-grade glioma. Cancer, 125(17), 3050-3058. https://doi.org/10.1002/cncr.32186