Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Child's Nervous System
Published in: Child's Nervous System 11/2017

01-11-2017 | Original Paper

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

Authors: 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

Published in: Child's Nervous System | Issue 11/2017

Login to get access

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.
Appendix
Available only for authorised users
Footnotes
1
This questionnaire was completed by very few patients, so it was omitted from the statistical analysis.
 
Literature
1.
Eurocare Working Group (2005) Childhood cancer survival trends in Europe: a EUROCARE working group study. J Clin Oncol 23:3742–3751CrossRef
2.
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.
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.
Packer RJ, Rood BR, MacDonald TJ (2003) Medulloblastoma: present concepts of stratification into risk groups. Pediatr Neurosurg 39:60–67CrossRefPubMed
5.
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.
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.
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.
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.
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.
Massimino M, Biassoni V, Gandola L et al (2016) Childhood medulloblastoma. Crit Rev Oncol Hematol 105:35–51CrossRefPubMed
11.
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.
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.
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.
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.
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.
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.
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.
Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38:581–586CrossRefPubMed
19.
Apolone G, Mosconi PJ (1998) The Italian SF-36 Health Survey: translation, validation and norming. Clin Epidemiol 51(11):1025–1036CrossRef
20.
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.
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.
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.
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.
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.
Felce D, Perry J (1995) Quality of life: its definition and measurement. Res Dev Disabil 16:51–74CrossRefPubMed
26.
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.
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.
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.
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.
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.
Levine DN (1990) Unawareness of visual and sensorimotor defects: a hypothesis. Brain Cogn 13:233–281CrossRefPubMed
32.
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.
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.
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
Metadata
Title
Quality of life in long-term survivors treated for metastatic medulloblastoma with a hyperfractionated accelerated radiotherapy (HART) strategy
Authors
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
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 11/2017
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-017-3548-1

Other articles of this Issue 11/2017

Child's Nervous System 11/2017 Go to the issue

Case Report

A rare case report and literatures review on primary germinoma in cerebellar hemisphere

Original Paper

A retrospective review of 34 cases of pediatric pituitary adenoma

Author’s Reply

In reply to “Letter to the Editor: Fetal ventriculomegaly: Diagnosis, treatment, and future directions.”

Letter to the Editor

Letter to the Editor: Presentation of extrapontine myelinolysis associated with hypernatremia in an infant: a case report

Erratum

Erratum to: Notomelia and related neural tube defects in a baby born in Niger: case report and literature review

Case Report

Extensive brain infarction involving deep structures during an acetazolamide-challenged single-photon emission computed tomography scan in a patient with moyamoya disease