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Health related quality of life (HRQOL) in long-term survivors of pediatric low grade gliomas (LGGs)

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Abstract

The purpose of this study was to assess the health-related quality of life (HRQOL) and the impact of treatment on HRQOL in long-term survivors of pediatric low-grade gliomas (LGGs) using an adult instrument. QOL of 121 patients with a diagnosis of LGG from the Mayo Clinic were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30 for cancer in general) and (EORTC QLQ-BN20 specific for brain tumors). Median follow-up was 21.9 years for the participants. Median age at diagnosis was 11.8 years and at assessment was 33 years. Mean (standard deviation) global QOL score for the study was 78 (18) and 76.4 (22.8) in a reference population of healthy adults. Using QLQ-C30, radiation treated patients compared to non-radiation patients reported lower physical functioning (p = 0.002), role functioning (p = 0.004), and more constipation problems (p < 0.001). Patients with tumor recurrence reported lower role functioning (p = 0.016), social functioning (p = 0.040), and more financial problems (p = 0.029) compared to their counterparts. Using QLQ-BN20, patients with deep tumors compared to cortical tumors reported more bladder control problems (p = 0.016). Radiation treated patients also reported more bladder control problems (p < 0.001) compared to their counterparts. In the multivariable analysis, radiation therapy remained an independent predictor of physical and role functioning as well as symptoms related to brain tumors like visual disorders and motor dysfunction. Global QOL of long-term survivors of pediatric LGGs is similar to that of a reference population of healthy adults. The following tumor and treatment related factors were most consistently associated with poorer QOL: CNS tumor location, post-operative radiation, and tumor recurrence. Future studies are necessary to identify strategies to improve QOL in this subgroup of patients.

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Acknowledgments

Parts of this work were presented at the 2013 American Society for Therapeutic Radiation Oncology (ASTRO) annual meeting in Atlanta, and the 2013 Society for Neuro-oncology (SNO) annual meeting in San Francisco.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Mayo Medical School, College of Medicine, Mayo Clinic, Rochester, MN, USA

    Chika R. Nwachukwu & Ryan S. Youland

  2. Department of Health Studies, University of Minnesota, Minneapolis, MN, 55455, USA

    Catherine Chioreso

  3. Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA

    Nicholas Wetjen

  4. Department of Pediatric Hematology Oncology, Mayo Clinic, Rochester, MN, USA

    Amulya NageswaraRao

  5. Department of Neurology, Mayo Clinic, Rochester, MN, USA

    Gesina Keating

  6. Department of Radiation Oncology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA

    Nadia N. Laack

Authors
  1. Chika R. Nwachukwu
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  2. Ryan S. Youland
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  3. Catherine Chioreso
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  5. Amulya NageswaraRao
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  7. Nadia N. Laack
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Correspondence to Nadia N. Laack.

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Nwachukwu, C.R., Youland, R.S., Chioreso, C. et al. Health related quality of life (HRQOL) in long-term survivors of pediatric low grade gliomas (LGGs). J Neurooncol 121, 599–607 (2015). https://doi.org/10.1007/s11060-014-1673-1

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  • DOI: https://doi.org/10.1007/s11060-014-1673-1

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