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Erschienen in: Child's Nervous System 11/2017

02.08.2017 | Original Paper

Quality of life in long-term survivors treated for metastatic medulloblastoma with a hyperfractionated accelerated radiotherapy (HART) strategy

verfasst von: L. Veneroni, L. Boschetti, F. Barretta, C. A. Clerici, F. Simonetti, E. Schiavello, V. Biassoni, F. Spreafico, L. Gandola, E. Pecori, B. Diletto, G. Poggi, F. Gariboldi, R. Sensi, M. Massimino

Erschienen in: Child's Nervous System | Ausgabe 11/2017

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Abstract

Purpose

An intensive therapeutic strategy for metastatic medulloblastoma was launched in 1998 in our Institution. The aim of this study was to examine the long-term quality of life (QoL) in survivor patients at least 3 years after the end of the treatment.

Methods

Patients were asked to complete self-administered QoL questionnaires. An index of physical impairment (IPI) was scored (range 0–100; the lower the score the better) based on clinical objective observations. Patients were divided into two groups (lower IPI group, and higher IPI group) and descriptively compared accordingly.

Results

The study was completed by 25/33 eligible patients. Despite patients with a higher IPI reported worse perceived health condition, they had better emotional and psychological scores than those with a lower IPI in all QoL questionnaires.

Conclusion

In our sample, patients with more severe objective and perceived physical impairments reported a better psychosocial QoL, possibly because the greater attention paid to them by society and family contributes to a better adjustment in long-term survivors. On this base, it should be recommended that all survivors receive a strong support as the most impaired patients.
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Fußnoten
1
This questionnaire was completed by very few patients, so it was omitted from the statistical analysis.
 
Literatur
1.
Zurück zum Zitat Eurocare Working Group (2005) Childhood cancer survival trends in Europe: a EUROCARE working group study. J Clin Oncol 23:3742–3751CrossRef Eurocare Working Group (2005) Childhood cancer survival trends in Europe: a EUROCARE working group study. J Clin Oncol 23:3742–3751CrossRef
2.
Zurück zum Zitat Crocetti E, Trama A, Stiller C et al (2012) Epidemiology of glial and non-glial brain tumours in Europe. Eur J Cancer 48(10):1532–1542 Crocetti E, Trama A, Stiller C et al (2012) Epidemiology of glial and non-glial brain tumours in Europe. Eur J Cancer 48(10):1532–1542
3.
Zurück zum Zitat Gatta G, Zigon G, Capocaccia R et al (2009) Survival of European children and young adults with cancer diagnosed 1995–2002. Eur J Cancer 45(6):992–1005CrossRefPubMed Gatta G, Zigon G, Capocaccia R et al (2009) Survival of European children and young adults with cancer diagnosed 1995–2002. Eur J Cancer 45(6):992–1005CrossRefPubMed
4.
Zurück zum Zitat Packer RJ, Rood BR, MacDonald TJ (2003) Medulloblastoma: present concepts of stratification into risk groups. Pediatr Neurosurg 39:60–67CrossRefPubMed Packer RJ, Rood BR, MacDonald TJ (2003) Medulloblastoma: present concepts of stratification into risk groups. Pediatr Neurosurg 39:60–67CrossRefPubMed
5.
Zurück zum Zitat Packer RJ, Gajjar A, Vezina G et al (2006) Phase III study of craniospinal radiation therapy followed by adjuvant chemotherapy for newly diagnosed average-risk medulloblastoma. J Clin Oncol 24:4202–4208CrossRefPubMed Packer RJ, Gajjar A, Vezina G et al (2006) Phase III study of craniospinal radiation therapy followed by adjuvant chemotherapy for newly diagnosed average-risk medulloblastoma. J Clin Oncol 24:4202–4208CrossRefPubMed
6.
Zurück zum Zitat Lannering B, Rutkowski S, Doz F et al (2012) Hyperfractionated versus conventional radiotherapy followed by chemotherapy in standard-risk medulloblastoma: results from the randomized multicenter HIT-SIOP PNET 4 trial. J Clin Oncol 30:3187–3193CrossRefPubMed Lannering B, Rutkowski S, Doz F et al (2012) Hyperfractionated versus conventional radiotherapy followed by chemotherapy in standard-risk medulloblastoma: results from the randomized multicenter HIT-SIOP PNET 4 trial. J Clin Oncol 30:3187–3193CrossRefPubMed
7.
Zurück zum Zitat Lefkowitz IB, Packer RJ, Siegel KR, Sutton LN, Schut L, Evans AE (1990) Results of treatment of children with recurrent medulloblastoma/primitive neuroectodermal tumors with lomustine, cisplatin, and vincristine. Cancer 65(3):412–417CrossRefPubMed Lefkowitz IB, Packer RJ, Siegel KR, Sutton LN, Schut L, Evans AE (1990) Results of treatment of children with recurrent medulloblastoma/primitive neuroectodermal tumors with lomustine, cisplatin, and vincristine. Cancer 65(3):412–417CrossRefPubMed
8.
Zurück zum Zitat Gajjar A, Chintagumpala M, Ashley D et al (2006) Risk-adapted craniospinal radiotherapy followed by high-dose chemotherapy and stem-cell rescue in children with newly diagnosed medulloblastoma (St Jude Medulloblastoma-96): long-term results from a prospective, multicentre trial. Lancet Oncol 7(10):813–820CrossRefPubMed Gajjar A, Chintagumpala M, Ashley D et al (2006) Risk-adapted craniospinal radiotherapy followed by high-dose chemotherapy and stem-cell rescue in children with newly diagnosed medulloblastoma (St Jude Medulloblastoma-96): long-term results from a prospective, multicentre trial. Lancet Oncol 7(10):813–820CrossRefPubMed
9.
Zurück zum Zitat Gandola L, Massimino M, Cefalo G et al (2009) Hyperfractionated accelerated radiotherapy in the Milan strategy for metastatic medulloblastoma. J Clin Oncol 27(4):566–571CrossRefPubMed Gandola L, Massimino M, Cefalo G et al (2009) Hyperfractionated accelerated radiotherapy in the Milan strategy for metastatic medulloblastoma. J Clin Oncol 27(4):566–571CrossRefPubMed
10.
Zurück zum Zitat Massimino M, Biassoni V, Gandola L et al (2016) Childhood medulloblastoma. Crit Rev Oncol Hematol 105:35–51CrossRefPubMed Massimino M, Biassoni V, Gandola L et al (2016) Childhood medulloblastoma. Crit Rev Oncol Hematol 105:35–51CrossRefPubMed
11.
Zurück zum Zitat Lassaletta A, Bouffet E, Mabbott D, Kulkarni AV (2015) Functional and neuropsychological late outcomes in posterior fossa tumors in children. Childs Nerv Syst 31(10):1877–1890CrossRefPubMed Lassaletta A, Bouffet E, Mabbott D, Kulkarni AV (2015) Functional and neuropsychological late outcomes in posterior fossa tumors in children. Childs Nerv Syst 31(10):1877–1890CrossRefPubMed
12.
Zurück zum Zitat Moxon-Emre I, Bouffet E, Taylor MD et al (2014) Impact of craniospinal dose, boost volume, and neurologic complications on intellectual outcome in patients with medulloblastoma. J Clin Oncol 32:1760–1768CrossRefPubMed Moxon-Emre I, Bouffet E, Taylor MD et al (2014) Impact of craniospinal dose, boost volume, and neurologic complications on intellectual outcome in patients with medulloblastoma. J Clin Oncol 32:1760–1768CrossRefPubMed
13.
Zurück zum Zitat Maddrey AM, Bergeron JA, Lombardo ER et al (2005) Neuropsychological performance and quality of life of 10-year survivors of childhood medulloblastoma. J Neuro-Oncol 72(3):245–253CrossRef Maddrey AM, Bergeron JA, Lombardo ER et al (2005) Neuropsychological performance and quality of life of 10-year survivors of childhood medulloblastoma. J Neuro-Oncol 72(3):245–253CrossRef
14.
Zurück zum Zitat Limond JA, Bull KS, Calaminus G, Kennedy CR, Spoudeas HA, Chevignard MP, Brain Tumour Quality of Survival Group, International Society of Paediatric Oncology (Europe) (SIOP-E) (2015) Quality of survival assessment in European childhood brain tumour trials, for children aged 5 years and over. Eur J Paediatr Neurol 19(2):202–210CrossRefPubMed Limond JA, Bull KS, Calaminus G, Kennedy CR, Spoudeas HA, Chevignard MP, Brain Tumour Quality of Survival Group, International Society of Paediatric Oncology (Europe) (SIOP-E) (2015) Quality of survival assessment in European childhood brain tumour trials, for children aged 5 years and over. Eur J Paediatr Neurol 19(2):202–210CrossRefPubMed
15.
Zurück zum Zitat Kennedy C, Bull K, Chevignard M et al (2014) Quality of survival and growth in children and young adults in the PNET4 European controlled trial of hyperfractionated versus conventional radiation therapy for standard-risk medulloblastoma. Int J Radiat Oncol Biol Phys 88(2):292–300CrossRefPubMed Kennedy C, Bull K, Chevignard M et al (2014) Quality of survival and growth in children and young adults in the PNET4 European controlled trial of hyperfractionated versus conventional radiation therapy for standard-risk medulloblastoma. Int J Radiat Oncol Biol Phys 88(2):292–300CrossRefPubMed
16.
Zurück zum Zitat Bull KS, Kennedy CR, Bailey S, Ellison DW, Clifford SC (2014) Improved health-related quality of life outcomes associated with SHH subgroup medulloblastoma in SIOP-UKCCSG PNET3 trial survivors. Acta Neuropathol 128(1):151–153CrossRefPubMedPubMedCentral Bull KS, Kennedy CR, Bailey S, Ellison DW, Clifford SC (2014) Improved health-related quality of life outcomes associated with SHH subgroup medulloblastoma in SIOP-UKCCSG PNET3 trial survivors. Acta Neuropathol 128(1):151–153CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Varni JW, Seid M, Rode CA (1999) The PedsQL: measurement model for the pediatric quality of life inventory. Med Care 37(2):126–139CrossRefPubMed Varni JW, Seid M, Rode CA (1999) The PedsQL: measurement model for the pediatric quality of life inventory. Med Care 37(2):126–139CrossRefPubMed
18.
Zurück zum Zitat Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38:581–586CrossRefPubMed Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38:581–586CrossRefPubMed
19.
Zurück zum Zitat Apolone G, Mosconi PJ (1998) The Italian SF-36 Health Survey: translation, validation and norming. Clin Epidemiol 51(11):1025–1036CrossRef Apolone G, Mosconi PJ (1998) The Italian SF-36 Health Survey: translation, validation and norming. Clin Epidemiol 51(11):1025–1036CrossRef
20.
Zurück zum Zitat Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376CrossRefPubMed Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376CrossRefPubMed
21.
Zurück zum Zitat Taphoorn MJ, Claassens L, Aaronson NK et al (2010) An international validation study of the EORTC brain cancer module (EORTC QLQ-BN20) for assessing health-related quality of life and symptoms in brain cancer patients. Eur J Cancer 46(6):1033–1040CrossRefPubMed Taphoorn MJ, Claassens L, Aaronson NK et al (2010) An international validation study of the EORTC brain cancer module (EORTC QLQ-BN20) for assessing health-related quality of life and symptoms in brain cancer patients. Eur J Cancer 46(6):1033–1040CrossRefPubMed
22.
Zurück zum Zitat Habets EJ, Taphoorn MJ, Nederend S et al (2014) Health-related quality of life and cognitive functioning in long-term anaplastic oligodendroglioma and oligoastrocytoma survivors. J Neuro-Oncol 116(1):161–168CrossRef Habets EJ, Taphoorn MJ, Nederend S et al (2014) Health-related quality of life and cognitive functioning in long-term anaplastic oligodendroglioma and oligoastrocytoma survivors. J Neuro-Oncol 116(1):161–168CrossRef
23.
Zurück zum Zitat Nwachukwu CR, Youland RS, Chioreso C et al (2015) Health related quality of life (HRQOL) in long-term survivors of pediatric low grade gliomas (LGGs). J Neurooncol 121(3):599–607CrossRefPubMed Nwachukwu CR, Youland RS, Chioreso C et al (2015) Health related quality of life (HRQOL) in long-term survivors of pediatric low grade gliomas (LGGs). J Neurooncol 121(3):599–607CrossRefPubMed
24.
Zurück zum Zitat Gudrunardottir T, Lannering B, Remke M, Taylor MD, Wells EM, Keating RF, Packer RJ (2014) Treatment developments and the unfolding of the quality of life discussion in childhood medulloblastoma: a review. Childs Nerv Syst 30(6):979–990CrossRefPubMed Gudrunardottir T, Lannering B, Remke M, Taylor MD, Wells EM, Keating RF, Packer RJ (2014) Treatment developments and the unfolding of the quality of life discussion in childhood medulloblastoma: a review. Childs Nerv Syst 30(6):979–990CrossRefPubMed
25.
Zurück zum Zitat Felce D, Perry J (1995) Quality of life: its definition and measurement. Res Dev Disabil 16:51–74CrossRefPubMed Felce D, Perry J (1995) Quality of life: its definition and measurement. Res Dev Disabil 16:51–74CrossRefPubMed
26.
Zurück zum Zitat Kulkarni AV, Piscione J, Shams I, Bouffet E (2013) Long-term quality of life in children treated for posterior fossa brain tumors. J Neurosurg Pediatr 12(3):235–240CrossRefPubMed Kulkarni AV, Piscione J, Shams I, Bouffet E (2013) Long-term quality of life in children treated for posterior fossa brain tumors. J Neurosurg Pediatr 12(3):235–240CrossRefPubMed
27.
Zurück zum Zitat Frange P, Alapetite C, Gaboriaud G et al (2009) From childhood to adulthood: long-term outcome of medulloblastoma patients. The Institut Curie experience (1980-2000). J Neurooncol 95(2):271–279CrossRefPubMed Frange P, Alapetite C, Gaboriaud G et al (2009) From childhood to adulthood: long-term outcome of medulloblastoma patients. The Institut Curie experience (1980-2000). J Neurooncol 95(2):271–279CrossRefPubMed
28.
Zurück zum Zitat Ribi K, Relly C, Landolt MA et al (2005) Outcome of medulloblastoma in children: long-term complications and quality of life. Neuropediatrics 36(6):357–365CrossRefPubMed Ribi K, Relly C, Landolt MA et al (2005) Outcome of medulloblastoma in children: long-term complications and quality of life. Neuropediatrics 36(6):357–365CrossRefPubMed
29.
Zurück zum Zitat Norderson A, Engstrom B, Norberg A (1998) Self-reported quality of life for patients with progressive neurological disease. Qual Life Res 7:257–266CrossRef Norderson A, Engstrom B, Norberg A (1998) Self-reported quality of life for patients with progressive neurological disease. Qual Life Res 7:257–266CrossRef
30.
Zurück zum Zitat Brinkman TM, Reddick WE, Luxton J et al (2012) Cerebral white matter integrity and executive function in adult survivors of childhood medulloblastoma. Neuro-Oncology 14(4):25–36 Brinkman TM, Reddick WE, Luxton J et al (2012) Cerebral white matter integrity and executive function in adult survivors of childhood medulloblastoma. Neuro-Oncology 14(4):25–36
31.
Zurück zum Zitat Levine DN (1990) Unawareness of visual and sensorimotor defects: a hypothesis. Brain Cogn 13:233–281CrossRefPubMed Levine DN (1990) Unawareness of visual and sensorimotor defects: a hypothesis. Brain Cogn 13:233–281CrossRefPubMed
32.
Zurück zum Zitat Ajovalasit D, Vago C, Usilla A et al (2009) Use of ICF to describe functioning and disability in children with brain tumours. Disabil Rehabil 31(1):100–107CrossRef Ajovalasit D, Vago C, Usilla A et al (2009) Use of ICF to describe functioning and disability in children with brain tumours. Disabil Rehabil 31(1):100–107CrossRef
33.
Zurück zum Zitat Khakban A, Mohammadi T, Lynd LD (2016) Societal preferences in the treatment of pediatric medulloblastoma: Balancing risk of death and quality of life. Pediatr Blood Cancer. doi:10.1002/pbc.26340 Khakban A, Mohammadi T, Lynd LD (2016) Societal preferences in the treatment of pediatric medulloblastoma: Balancing risk of death and quality of life. Pediatr Blood Cancer. doi:10.​1002/​pbc.​26340
34.
Zurück zum Zitat Hoppe-Hirsch E, Brunet L, Laroussinie F et al (1995) Intellectual outcome in children with malignant tumors of the posterior fossa: influence of the field of irradiation and quality of surgery. Childs Nerv Syst 11(6):340–345CrossRefPubMed Hoppe-Hirsch E, Brunet L, Laroussinie F et al (1995) Intellectual outcome in children with malignant tumors of the posterior fossa: influence of the field of irradiation and quality of surgery. Childs Nerv Syst 11(6):340–345CrossRefPubMed
Metadaten
Titel
Quality of life in long-term survivors treated for metastatic medulloblastoma with a hyperfractionated accelerated radiotherapy (HART) strategy
verfasst von
L. Veneroni
L. Boschetti
F. Barretta
C. A. Clerici
F. Simonetti
E. Schiavello
V. Biassoni
F. Spreafico
L. Gandola
E. Pecori
B. Diletto
G. Poggi
F. Gariboldi
R. Sensi
M. Massimino
Publikationsdatum
02.08.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 11/2017
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-017-3548-1

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