Memory impairment and neurocognitive deficits reduce the health-related
quality of life in medulloblastoma survivors
Abstract
Background Survivors of childhood medulloblastoma are particularly
susceptible to late effects because of the location of the tumour and
the treatment required to achieve a cure. Living with these long-term
toxicities is challenging and greater understanding of the impact of the
disease and treatment have on health-related quality of life (HRQoL) is
needed. Procedure We report a cross-sectional study to assess patient
HRQoL outcomes for 52 long-term survivors of medulloblastoma aged 1–25
years of age at diagnosis and treated during a ten-year period at The
Royal Marsden Hospital. Child self-reports and parent – proxy reports
of PedsQL scores correlate with clinical information, long-term toxicity
(assessed using CTCAE) and neurocognitive assessment (using WISC-IV) to
examine the impact that disease and treatment have on HRQoL after
treatment. Results Reported late toxicities included ataxia (62%),
hearing impairment (59%), endocrine disorders (57%) and memory
impairment (44%). Reduced HRQoL outcome scores for patients showed a
significant correlation with reduced verbal comprehension (0.51;
p=0.025), and processing speed (0.5; p=0.04). Memory impairment showed
significant association with the cancer module PedsQL (p=0.024) scores.
Parents’ perception of their child’s quality of life was lower than the
patient’s self-assessment (mean 55.9 for parents and 63.8 for patients,
p=0.004). Conclusions The findings from this study confirm the impact of
late toxicities and neurocognitive sequelae on HRQoL in patients
previously treated for medulloblastoma in childhood and adolescence. In
particular verbal comprehension, processing speed and memory impairment
influence patient reported outcomes in this cohort.