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Adverse medical events associated with childhood cerebellar astrocytomas and medulloblastomas: natural history and relation to very long-term neurobehavioral outcome

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Abstract

Objectives

The objectives of the study are to document the incidence of medical events in survivors of childhood posterior fossa astrocytoma or medulloblastoma in four time periods (diagnosis, perioperative, short-term survival, long-term survival), and to study whether medical events predict neurobehavioral outcome.

Materials and methods

Twenty-nine astrocytoma and 29 medulloblastoma survivors were studied at least 5 years post-diagnosis. The incidence of medical events in each time period was compared in each group in relation to long-term intelligence, memory, functional independence, and health-related quality of life. As expected, medical and neurobehavioral outcome were poorer in the medulloblastoma group. In the astrocytoma group, poorer long-term neurobehavioral outcome was associated with more adverse medical events in the perioperative and short-term survival periods.

Conclusions

Long-term neurobehavioral outcome is related to time-dependent medical events in astrocytoma survivors. The data confirm earlier reports of poorer outcome after medulloblastoma and add new information about clinical markers of poor neurobehavioral outcome in survivors of childhood astrocytoma.

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Acknowledgements

A portion of the data was presented at the Twenty-Ninth Annual International Neuropsychological Society Conference, February 14–17, 2001, Chicago, Illinois. The published abstract is referenced as follows: Spiegler, BJ, Roncadin, C, Dennis, M, Greenberg, M (2001) Predicting adaptive outcome from medical events in children after cerebellar tumors [Abstract]. J Int Neuropsychol Soc 7:213–214. Mark L. Greenberg holds the POGO Chair in childhood cancer control at the University of Toronto. We thank Susan Berry for commenting on earlier drafts of this work.

Funding

The authors have no potential conflicts of interest or financial interest in the subject of this manuscript. The work reported here was conducted at The Hospital for Sick Children in Toronto, Canada, and the cognitive data were collected as part of a larger study supported by the National Cancer Institute of Canada.

Author information

Authors and Affiliations

  1. Peel Children’s Centre, 85A Aventura Court, Mississauga, ON, L5T 2Y6, Canada

    Caroline Roncadin

  2. McMaster University, Hamilton, ON, Canada

    Caroline Roncadin

  3. Hospital for Sick Children, Toronto, ON, Canada

    Maureen Dennis, Mark L. Greenberg & Brenda J. Spiegler

  4. University of Toronto, Toronto, ON, Canada

    Maureen Dennis, Mark L. Greenberg & Brenda J. Spiegler

Authors
  1. Caroline Roncadin
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  2. Maureen Dennis
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  3. Mark L. Greenberg
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  4. Brenda J. Spiegler
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Corresponding author

Correspondence to Caroline Roncadin.

Additional information

A commentary on this paper is available at doi: 10.1007/s00381-008-0661-1.

Appendix

Appendix

Table 4 Frequency of medical events by symptom cluster for each tumor group in each time period
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Roncadin, C., Dennis, M., Greenberg, M.L. et al. Adverse medical events associated with childhood cerebellar astrocytomas and medulloblastomas: natural history and relation to very long-term neurobehavioral outcome. Childs Nerv Syst 24, 995–1002 (2008). https://doi.org/10.1007/s00381-008-0658-9

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  • DOI: https://doi.org/10.1007/s00381-008-0658-9

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