Outcome of children with brain tumours diagnosed in the first year: long-term complications and quality of life

Nicolas U Gerber ¹, Daniel Zehnder ¹, Tycho Zuzak ¹, Andrea Poretti ¹, Eugen Boltshauser ¹ and Michael A Grotzer ^1*

¹ University Children's Hospital of Zurich, Switzerland

^* To whom correspondence should be addressed. E-mail: michael.grotzer{at}kispi.unizh.ch.

Accepted 25 June 2007

Abstract

Object: To study the outcome in children with brain tumours diagnosed in the first year of life, we followed up 27 consecutive children who were diagnosed between 1980 and 2005 in a single institution.

Methods: In 11 survivors (mean follow-up time 12.3 years), tumour control, neurological, endocrine, and cognitive complications, and their impact on behavioural and emotional adjustment and health-related quality of life (HRQoL) were comprehensively assessed.

Results: Persistent neurological complications occurred in 9/11 patients, endocrine and growth complications in 4/11, and cognitive deficits leading to school problems/impaired choice of occupation in 8/10. Behavioural and psychological adjustment problems were reported by 4/6 patients and 7/10 parents. HRQoL as rated by patients and their parents was considerably lower than that of healthy controls. In comparison with healthy controls, social functioning was rated by the patients and the parents as the QoL dimension most affected. HRQoL was lowest for patients with high-grade tumour histology and more intense therapy.

Conclusion: Long term survivors of brain tumours diagnosed in the first year of life are not only at great risk of neurological and cognitive complications, but also of social isolation thereby decreasing self-rated HRQoL substantially.

Keywords: brain neoplasms, child, infant, outcome assessment, quality of life

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