Health status, health-related quality of life, and socioeconomic outcome in childhood brain tumor survivors: a German cohort study

Abstract Background With rising numbers of childhood cancer survivors, somatic and socioeconomic outcome as well as health-related quality of life (QoL) gain increasing relevance. Based on the first nationwide German Survey on Life Situation, State of Health, and Quality of Life of Childhood Cancer Survivors, the VIVE survey, we report the outcome of survivors of childhood brain tumors localized in the posterior fossa. Methods Two hundred seventy participants with a median follow-up period of 21.9 years completed a questionnaire on socioeconomic and somatic late effects as well as a standardized QoL questionnaire (European Organisation for Research and Treatment of Cancer QLQ-C30). Comparisons were performed between World Health Organization (WHO) grades I–II, WHO grades III–IV brain tumor survivors (BTS), and the general population adjusting for potential confounders. Results The socioeconomic and QoL results of WHO grades I–II BTS were largely comparable to the general population, while grades III–IV BTS were at higher risk for significantly worse outcomes. Of WHO grades III–IV BTS, 36.8% were still living with their parents or in assisted living facilities compared with 16.1% of grades I–II BTS and 7.8% of the age-adjusted general population. Of grades III–IV BTS, 60.8% achieved at least an intermediate school degree in comparison to 80.5% of grades I–II BTS and 75.6% of the general population. Grades III–IV BTS developed up to 2 times more somatic late effects than survivors of grades I–II tumors. Conclusion Derived from a large and homogeneous cohort, these results stress the importance of an appropriate follow-up period focusing not only on physical aspects but encompassing the entire living situation to allow patient-tailored support.

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Disability, Health-Related Quality of Life and Mortality in Lumbar Spine Fusion Patients—A 5-Year Follow-Up and Comparison With a Population Sample

Global Spine Journal ◽

10.1177/2192568220972977 ◽

2020 ◽

pp. 219256822097297

Author(s):

Leevi Toivonen ◽

Liisa Pekkanen ◽

Marko H. Neva ◽

Hannu Kautiainen ◽

Kati Kyrölä ◽

...

Keyword(s):

Quality Of Life ◽

Lumbar Spine ◽

General Population ◽

Spine Fusion ◽

Health Related Quality ◽

Lumbar Spine Fusion ◽

Related Quality ◽

Health Related

Study Design: Prospective follow-up study. Objectives: We aimed to assess the effect of lumbar spine fusion (LSF) on disability, health-related quality of life and mortality in a 5-year follow-up, and to compare these results with the general population. Methods: 523 consecutive LSF operations were included in a prospective follow-up. Disability was assessed by the Oswestry Disability Index (ODI), and HRQoL by the 36-item Short Form (SF-36) questionnaire using the physical and mental summary scores (PCS and MCS). The patients were compared with an age-, sex-, and residential area matched general population cohort. Results: The preoperative ODI in the patients was 46 (SD 16), and the change at 5 years was −26 (95% CI: −24 to −28), p < 0.001. In the population, ODI (baseline 13, SD 16) remained unchanged. The preoperative PCS in the patients was 27 (SD 7), in the population 45 (SD 11), and the increase in the patients at 5 years was 8 (95% CI: 7 to 9), p < 0.001. The patients did not reach the population in ODI or PCS. The baseline MCS in the patients was 47 (SD 13), and the change at 5 years 4 (95% CI: 3 to 7), p < 0.001. MCS of the females reached the population at 5-year follow-up. When analyzing short and long fusions separately, comparable changes were seen in both subgroups. There was no difference in mortality between the patients (3.4%) and the population (4.8%), hazard ratio (HR) 0.86. Conclusions: Although the patients who had undergone LSF benefited from surgery still at 5 years, they never reached the physical level of the population.

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Health-Related Quality of Life and Return to Work after Surgery for Spinal Meningioma: A Population-Based Cohort Study

Cancers ◽

10.3390/cancers13246371 ◽

2021 ◽

Vol 13 (24) ◽

pp. 6371

Author(s):

Jenny Pettersson-Segerlind ◽

Ann-Christin von von Vogelsang ◽

Alexander Fletcher-Sandersjöö ◽

Charles Tatter ◽

Tiit Mathiesen ◽

...

Keyword(s):

Quality Of Life ◽

General Population ◽

Return To Work ◽

Health Related Quality ◽

Spinal Meningioma ◽

Related Quality ◽

Health Related ◽

Spinal Meningiomas

Spinal meningiomas are the most common primary spinal intradural tumor. This study aimed to assess Health-related quality of life (HRQoL) and the frequency of return to work in patients surgically treated for spinal meningiomas, in comparison to the general population. Variables were collected from patient charts, EQ-5D-3L, and study specific questionnaires. Patients who had been operated between 2005–2017 were identified in a previous study and those alive in 2020 (104 of 129) were asked to participate. Eighty-four patients (80.8%) with a mean follow-up of 8.7 years, responded and were included. Data was compared to the Stockholm Public Health Survey 2006, a cross-sectional survey of a representative sample of the general population. Analysis for potential non-response bias showed no significant differences. Women in the meningioma sample scored more problems than men with regards to mobility (p = 0.048). There were no significant differences concerning EQ-5Dindex (p = 0.325) or EQVAS (p = 0.116). The correlation between follow-up time and EQ-5Dindex was low (r = 0.167). When comparing HRQoL to the general population sample, no significant differences were found within the EQ-5D-3L dimensions, EQ-5Dindex or EQVAS. Those who postoperatively scored 3–5 on mMCs scored significantly more problems in the EQ-5D-3L dimension mobility (p = 0.023). Before surgery, 41 (48.8%) of the spinal meningioma patients were working and after surgery all returned to work, the majority within three months. Seventy-eight (96%) of the patients would accept surgery for the same diagnosis if asked today. We conclude that surgery for spinal meningiomas is associated with good long-term HRQoL and a high frequency of return to work.

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Long-term health-related quality of life in pediatric brain tumor survivors receiving proton radiotherapy at <4 years of age

Neuro-Oncology ◽

10.1093/neuonc/noaa042 ◽

2020 ◽

Vol 22 (9) ◽

pp. 1379-1387 ◽

Cited By ~ 1

Author(s):

Bree R Eaton ◽

Saveli Goldberg ◽

Nancy J Tarbell ◽

Miranda P Lawell ◽

Sara L Gallotto ◽

...

Keyword(s):

Quality Of Life ◽

Brain Tumor ◽

Young Age ◽

Healthy Children ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Abstract Background The purpose of this analysis is to report long-term health-related quality of life (HRQoL) among brain tumor survivors treated with proton therapy (PRT) at a very young age. Methods Fifty-nine children <4 years old received PRT between 2000 and 2011. Forty families participated. HRQoL was assessed by child self-report (CSR; age ≥5) and parent proxy report (PPR; age 2+) using the PedsQL Core. Results The median age was 2.5 years (range, 0.3–3.8) at PRT and 9.1 years (5.5–18) at last follow-up. The most common diagnoses were ependymoma (n = 22) and medulloblastoma (n = 7). Median follow-up is 6.7 years (3–15.4). Follow-up mean CSR and PPR scores were: total core (78.4 and 72.9), physical (82.9 and 75.2), psychosocial (76.0 and 71.6), emotional (74.4 and 70.7), social (81.2 and 75.1), and school (72.4 and 69.9). Parent-reported HRQoL fell within a previously defined range for healthy children in 37.5% of patients, and for children with severe health conditions in 45% of patients. PPR HRQoL was stable from baseline to last follow-up among all domains except for social functioning. History of gastrostomy tube was significantly associated with poorer CSR and PPR HRQoL on multivariable analysis. Ninety percent of children functioned in a regular classroom, 14 (36%) used a classroom aid, 9 (23%) used an outside tutor, and 18 (46%) had an individualized education plan. Conclusion Long-term HRQoL among brain tumor survivors treated with PRT at a very young age is variable, with over a third achieving HRQoL levels commensurate with healthy children. Key Points 1. One third of survivors reported long-term HRQoL scores comparable to those of healthy children. 2. Treatment for hydrocephalus or a feeding tube was associated with significantly lower HRQoL. 3. Total core HRQoL scores remained stable from baseline to last follow-up.

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