Neuropsychological and socioeconomic outcomes in adult survivors of pediatric low-grade glioma

M. Douglas Ris, Wendy M. Leisenring, Pamela Goodman, Chongzhi Di, Jennie Noll, Wendy Levy, Leslie L. Robison, Gregory Armstrong

Research output: Contribution to journalArticle

Abstract

Background: Current estimates suggest that 75% of children diagnosed with a central nervous system (CNS) tumor will become 5-year survivors. However, survivors of childhood CNS tumors are at increased risk for long-term morbidity. Methods: To determine long-term neuropsychological and socioeconomic status (SES) outcomes, adult survivors of pediatric low-grade gliomas (n = 181) in the Childhood Cancer Survivor Study and a sibling comparison group that was frequency-matched by age and sex (n = 105) completed a comprehensive battery of standardized neuropsychological tests and an SES assessment. Multivariable regression models compared treatment-specific groups for neuropsychological and SES outcomes and evaluated associations with tumor location, age at diagnosis, sex, and age at evaluation. Results: In adjusted models, survivors treated with surgery and radiotherapy (surgery+RT; median age at diagnosis, 7 years; median age at assessment, 41 years) scored lower on estimated IQ than survivors treated with surgery only, who scored lower than siblings (surgery+RT, 93.9; surgery only, 101.2; siblings, 108.5; all P values <.0001). Survivors diagnosed at younger ages had low scores for all outcomes (P <.05) except for attention/processing speed. For SES outcomes, survivors treated with surgery+RT had lower occupation scores (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.1-5.9), lower income (OR, 2.6; 95% CI, 1.3-5.0), and less education (OR, 2.1; 95% CI, 1.1-4.0) than those treated with surgery only. Conclusions: Decades after treatment, survivors treated with radiotherapy and at younger ages had poorer neuropsychological and SES outcomes. Lifelong surveillance of survivors of pediatric low-grade gliomas may be warranted as life events, stages, and transitions (employment, family, and aging) present new challenges and risks.

Original languageEnglish (US)
Pages (from-to)3050-3058
Number of pages9
JournalCancer
Volume125
Issue number17
DOIs
StatePublished - Jan 1 2019

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Glioma
Survivors
Pediatrics
Social Class
Siblings
Central Nervous System Neoplasms
Odds Ratio
Confidence Intervals
Radiotherapy
Neuropsychological Tests
Occupations
Neoplasms
Morbidity
Education
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Ris, M. D., Leisenring, W. M., Goodman, P., Di, C., Noll, J., Levy, W., ... Armstrong, G. (2019). Neuropsychological and socioeconomic outcomes in adult survivors of pediatric low-grade glioma. Cancer, 125(17), 3050-3058. https://doi.org/10.1002/cncr.32186

Neuropsychological and socioeconomic outcomes in adult survivors of pediatric low-grade glioma. / Ris, M. Douglas; Leisenring, Wendy M.; Goodman, Pamela; Di, Chongzhi; Noll, Jennie; Levy, Wendy; Robison, Leslie L.; Armstrong, Gregory.

In: Cancer, Vol. 125, No. 17, 01.01.2019, p. 3050-3058.

Research output: Contribution to journalArticle

Ris, MD, Leisenring, WM, Goodman, P, Di, C, Noll, J, Levy, W, Robison, LL & Armstrong, G 2019, 'Neuropsychological and socioeconomic outcomes in adult survivors of pediatric low-grade glioma', Cancer, vol. 125, no. 17, pp. 3050-3058. https://doi.org/10.1002/cncr.32186
Ris MD, Leisenring WM, Goodman P, Di C, Noll J, Levy W et al. Neuropsychological and socioeconomic outcomes in adult survivors of pediatric low-grade glioma. Cancer. 2019 Jan 1;125(17):3050-3058. https://doi.org/10.1002/cncr.32186
Ris, M. Douglas ; Leisenring, Wendy M. ; Goodman, Pamela ; Di, Chongzhi ; Noll, Jennie ; Levy, Wendy ; Robison, Leslie L. ; Armstrong, Gregory. / Neuropsychological and socioeconomic outcomes in adult survivors of pediatric low-grade glioma. In: Cancer. 2019 ; Vol. 125, No. 17. pp. 3050-3058.
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abstract = "Background: Current estimates suggest that 75{\%} of children diagnosed with a central nervous system (CNS) tumor will become 5-year survivors. However, survivors of childhood CNS tumors are at increased risk for long-term morbidity. Methods: To determine long-term neuropsychological and socioeconomic status (SES) outcomes, adult survivors of pediatric low-grade gliomas (n = 181) in the Childhood Cancer Survivor Study and a sibling comparison group that was frequency-matched by age and sex (n = 105) completed a comprehensive battery of standardized neuropsychological tests and an SES assessment. Multivariable regression models compared treatment-specific groups for neuropsychological and SES outcomes and evaluated associations with tumor location, age at diagnosis, sex, and age at evaluation. Results: In adjusted models, survivors treated with surgery and radiotherapy (surgery+RT; median age at diagnosis, 7 years; median age at assessment, 41 years) scored lower on estimated IQ than survivors treated with surgery only, who scored lower than siblings (surgery+RT, 93.9; surgery only, 101.2; siblings, 108.5; all P values <.0001). Survivors diagnosed at younger ages had low scores for all outcomes (P <.05) except for attention/processing speed. For SES outcomes, survivors treated with surgery+RT had lower occupation scores (odds ratio [OR], 2.6; 95{\%} confidence interval [CI], 1.1-5.9), lower income (OR, 2.6; 95{\%} CI, 1.3-5.0), and less education (OR, 2.1; 95{\%} CI, 1.1-4.0) than those treated with surgery only. Conclusions: Decades after treatment, survivors treated with radiotherapy and at younger ages had poorer neuropsychological and SES outcomes. Lifelong surveillance of survivors of pediatric low-grade gliomas may be warranted as life events, stages, and transitions (employment, family, and aging) present new challenges and risks.",
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AU - Ris, M. Douglas

AU - Leisenring, Wendy M.

AU - Goodman, Pamela

AU - Di, Chongzhi

AU - Noll, Jennie

AU - Levy, Wendy

AU - Robison, Leslie L.

AU - Armstrong, Gregory

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N2 - Background: Current estimates suggest that 75% of children diagnosed with a central nervous system (CNS) tumor will become 5-year survivors. However, survivors of childhood CNS tumors are at increased risk for long-term morbidity. Methods: To determine long-term neuropsychological and socioeconomic status (SES) outcomes, adult survivors of pediatric low-grade gliomas (n = 181) in the Childhood Cancer Survivor Study and a sibling comparison group that was frequency-matched by age and sex (n = 105) completed a comprehensive battery of standardized neuropsychological tests and an SES assessment. Multivariable regression models compared treatment-specific groups for neuropsychological and SES outcomes and evaluated associations with tumor location, age at diagnosis, sex, and age at evaluation. Results: In adjusted models, survivors treated with surgery and radiotherapy (surgery+RT; median age at diagnosis, 7 years; median age at assessment, 41 years) scored lower on estimated IQ than survivors treated with surgery only, who scored lower than siblings (surgery+RT, 93.9; surgery only, 101.2; siblings, 108.5; all P values <.0001). Survivors diagnosed at younger ages had low scores for all outcomes (P <.05) except for attention/processing speed. For SES outcomes, survivors treated with surgery+RT had lower occupation scores (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.1-5.9), lower income (OR, 2.6; 95% CI, 1.3-5.0), and less education (OR, 2.1; 95% CI, 1.1-4.0) than those treated with surgery only. Conclusions: Decades after treatment, survivors treated with radiotherapy and at younger ages had poorer neuropsychological and SES outcomes. Lifelong surveillance of survivors of pediatric low-grade gliomas may be warranted as life events, stages, and transitions (employment, family, and aging) present new challenges and risks.

AB - Background: Current estimates suggest that 75% of children diagnosed with a central nervous system (CNS) tumor will become 5-year survivors. However, survivors of childhood CNS tumors are at increased risk for long-term morbidity. Methods: To determine long-term neuropsychological and socioeconomic status (SES) outcomes, adult survivors of pediatric low-grade gliomas (n = 181) in the Childhood Cancer Survivor Study and a sibling comparison group that was frequency-matched by age and sex (n = 105) completed a comprehensive battery of standardized neuropsychological tests and an SES assessment. Multivariable regression models compared treatment-specific groups for neuropsychological and SES outcomes and evaluated associations with tumor location, age at diagnosis, sex, and age at evaluation. Results: In adjusted models, survivors treated with surgery and radiotherapy (surgery+RT; median age at diagnosis, 7 years; median age at assessment, 41 years) scored lower on estimated IQ than survivors treated with surgery only, who scored lower than siblings (surgery+RT, 93.9; surgery only, 101.2; siblings, 108.5; all P values <.0001). Survivors diagnosed at younger ages had low scores for all outcomes (P <.05) except for attention/processing speed. For SES outcomes, survivors treated with surgery+RT had lower occupation scores (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.1-5.9), lower income (OR, 2.6; 95% CI, 1.3-5.0), and less education (OR, 2.1; 95% CI, 1.1-4.0) than those treated with surgery only. Conclusions: Decades after treatment, survivors treated with radiotherapy and at younger ages had poorer neuropsychological and SES outcomes. Lifelong surveillance of survivors of pediatric low-grade gliomas may be warranted as life events, stages, and transitions (employment, family, and aging) present new challenges and risks.

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