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Social attainment in survivors of pediatric central nervous system tumors: a systematic review and meta-analysis from the Children’s Oncology Group

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Abstract

Purpose

Improved therapies for pediatric central nervous system (CNS) tumors have increased survival rates; however, many survivors experience significant long-term functional limitations. Survivors of pediatric CNS tumors can experience deficits in social attainment. The aim of this review was to systematically amalgamate findings pertaining to social attainment (i.e., educational attainment, marriage, employment outcomes) in survivors of pediatric CNS tumors.

Methods

PubMed (web-based), PsycINFO (EBSCO), EMBASE (Ovid), and Web of Science (Thomson Reuters) were used to identify articles published between January 2011 and September 2018. Eligible studies reported outcomes for survivors of pediatric CNS tumors diagnosed before age 21 years and > 5 years from diagnosis and/or > 2 years off therapy. All data were independently abstracted by two reviewers. Random-effects meta-analyses were performed using Review Manager 5.0.

Results

The search yielded 7021 unique publications. Forty-six were included in the current review. Meta-analyses revealed survivors of CNS tumors were significantly more likely to have completed compulsory education only (OR = 1.87, 95% CI = 1.66, 2.12, p < 0.00001), less likely to be married (OR = 4.70, 95% CI = 3.89, 5.68, p < 0.00001), and more likely to be unemployed (OR = 2.84, 95% CI = 2.62, 3.08, p < 0.00001) compared to non-cancer controls. Cranial radiation therapy, neurocognitive deficits, and younger age at diagnosis were associated with poorer outcomes. Hearing loss and bilateral blindness were also related to poorer outcomes. Sex did not impact social attainment outcomes.

Conclusions

Survivors of pediatric CNS tumors are at elevated risk for poor attainment of key adult social outcomes.

Implications for Cancer Survivors

There is a critical need to develop interventions to support survivors in becoming independent and productive adults.

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Funding

This work was supported in part by the Children’s Oncology Group grant U10CA180886 from the National Cancer Institute and the St. Baldrick’s Foundation.

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Authors and Affiliations

  1. Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C3, Canada

    Fiona Schulte & Caitlin Forbes

  2. Alberta Children’s Hospital, Calgary, Canada

    Fiona Schulte

  3. University of Minnesota, Minneapolis, MN, USA

    Alicia S. Kunin-Batson

  4. HealthPartners Institute, Minneapolis, MN, USA

    Barbara A. Olson-Bullis

  5. St. Jude Children’s Research Hospital, Memphis, TN, USA

    Pia Banerjee & Kevin R. Krull

  6. Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Matthew C. Hocking

  7. University of Pennsylvania, Philadelphia, PA, USA

    Matthew C. Hocking

  8. Hospital for Sick Children, Toronto, Ontario, Canada

    Laura Janzen

  9. Baylor College of Medicine, Houston, TX, USA

    Lisa S. Kahalley

  10. University of British Columbia, Vancouver, BC, Canada

    Hayley Wroot

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  1. Fiona Schulte
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Correspondence to Fiona Schulte.

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Schulte, F., Kunin-Batson, A.S., Olson-Bullis, B.A. et al. Social attainment in survivors of pediatric central nervous system tumors: a systematic review and meta-analysis from the Children’s Oncology Group. J Cancer Surviv 13, 921–931 (2019). https://doi.org/10.1007/s11764-019-00808-3

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