Evolving therapies, neurocognitive outcomes, and functional independence in adult survivors of childhood glioma

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Evolving therapies, neurocognitive outcomes, and functional independence in adult survivors of childhood glioma

Papini, Chiara (författare): St Jude Children´s Research Hospital, Memphis

Mirzaei, Sedigheh S. (författare): St Jude Children´s Research Hospital, Memphis

Xing, Mengqi (författare): St Jude Children´s Research Hospital, Memphis

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Olsson, Ingrid Tonning (författare): Lund University,Lunds universitet,Pediatrik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Institutionen för psykologi,Samhällsvetenskapliga institutioner och centrumbildningar,Samhällsvetenskapliga fakulteten,Pediatrisk onkologi,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Paediatrics (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Department of Psychology,Departments of Administrative, Economic and Social Sciences,Faculty of Social Sciences,Pediatric Oncology,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital

de Blank, Peter M.K. (författare): Cincinnati Children's Hospital Medical Center

Lange, Katharine R. (författare)

Salloum, Ralph (författare)

Srivastava, Deokumar (författare): St Jude Children´s Research Hospital, Memphis

Leisenring, Wendy M. (författare): Fred Hutchinson Cancer Research Center

Howell, Rebecca M. (författare): University of Texas

Oeffinger, Kevin C. (författare): Duke University

Robison, Leslie L. (författare): St Jude Children´s Research Hospital, Memphis

Armstrong, Gregory T. (författare): St Jude Children´s Research Hospital, Memphis

Krull, Kevin R. (författare): St Jude Children´s Research Hospital, Memphis

Brinkman, Tara M. (författare): St Jude Children´s Research Hospital, Memphis

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(creator_code:org_t)

2024
2024
Engelska 11 s.
Ingår i: Journal of the National Cancer Institute. - 0027-8874. ; 116:2, s. 288-298

Relaterad länk:: http://dx.doi.org/10...; visa fler...; https://lup.lub.lu.s...; https://doi.org/10.1...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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Background: Treatment of childhood glioma has evolved to reduce radiotherapy exposure with the goal of limiting late toxicity. However, the associations between treatment changes and neurocognition, and the contribution of neurocognition and chronic health conditions to attainment of adult independence, remain unknown. Methods: Adult survivors of childhood glioma diagnosed in 1970-1999 in the Childhood Cancer Survivor Study (n ¼ 1284; median [minimum-maximum] 30 [18-51] years of age at assessment; 22 [15-34] years from diagnosis) self-reported neurocognitive impairment and chronic health conditions. Multivariable models evaluated associations between changes in treatment exposures (surgery only, chemotherapy [with or without surgery], cranial radiation [with or without chemotherapy and/or surgery]), and neurocognitive impairment. Latent class analysis with 5 indicators (employment, independent living, assistance with routine and/or personal care needs, driver’s license, marital or partner status) identified classes of functional independence. Path analysis tested associations among treatment exposures, neurocognitive impairment, chronic health conditions, and functional independence. Statistical tests were 2-sided. Results: Cranial radiation exposure decreased over time (51%, 1970s; 46%, 1980s; 27%, 1990s]. However, compared with siblings, survivors with any treatment exposure were at elevated risk for neurocognitive impairment, including surgery only (eg, memory: relative risk ¼ 2.22; task efficiency: relative risk ¼ 1.88; both P < .001). Three classes of functional independence were identified: independent (58%), moderately independent (20%), and nonindependent (22%). Cranial radiation was associated with nonindependence through impaired task efficiency (b ¼ 0.06), sensorimotor (b ¼ 0.06), and endocrine (b ¼ 0.10) chronic health conditions and through the associations between these conditions and task efficiency (each b ¼ 0.04). Sensorimotor and endocrine chronic health conditions were associated with nonindependence through memory. Conclusion: Most long-term glioma survivors achieve adult independence. However, functional nonindependence is associated with treatment-related neurocognitive impairment and chronic health conditions.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)

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