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  • [Cancer.] Quality of life in patients with proton-treated pediatric medulloblastoma: Results of a prospective assessment with 5-year follow-up.

    Massachusetts General Hospital / Torunn I. Yock*

  • 출처
    Cancer.
  • 등재일
    2018 Aug
  • 저널이슈번호
    124(16):3390-3400. doi: 10.1002/cncr.31575. Epub 2018 Jun 15.
  • 내용

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    Abstract
    BACKGROUND:
    To the authors' knowledge, health-related quality of life (HRQOL) outcomes are not well described in patients with medulloblastoma. The use of proton radiotherapy (RT) may translate into an improved HRQOL. In the current study, the authors report long-term HRQOL in patients with proton-treated pediatric medulloblastoma.

    METHODS:
    The current study was a prospective cohort HRQOL study of patients with medulloblastoma who were treated with proton RT and enrolled between August 5, 2002, and October 8, 2015. Both child report and parent-proxy report Pediatric Quality of Life Inventory (PedsQL) surveys were collected at baseline during RT and annually thereafter (score range on surveys of 0-100, with higher scores indicating better HRQOL). Patients were dichotomized by clinical/treatment variables and subgroups were compared. Mixed-model analysis was performed to determine the longitudinal trajectory of PedsQL scores. The Student t test was used to compare long-term HRQOL measures with published means from a healthy child population.

    RESULTS:
    Survey data were evaluable for 116 patients with a median follow-up of 5 years (range, 1-10.6 years); the median age at the time of diagnosis was 7.6 years (range, 2.1-18.1 years). At baseline, children reported a total core score (TCS) of 65.9, which increased by 1.8 points annually (P<.001); parents reported a TCS of 59.1, which increased by 2.0 points annually. Posterior fossa syndrome adversely affected baseline scores, but these scores significantly improved with time. At the time of last follow-up, children reported a TCS of 76.3, which was 3.3 points lower than that of healthy children (P = .09); parents reported a TCS of 69, which was 11.9 points lower than that of parents of healthy children (P<.001). Increased follow-up time from diagnosis correlated with improved HRQOL scores.

    CONCLUSIONS:
    HRQOL scores appear to increase over time after treatment in children treated with proton RT for medulloblastoma but remain lower compared with those of parent-proxy reports as well as published means from a healthy normative sample of children. Additional follow-up may translate into continued improvements in HRQOL.

     


    Author information

    Kamran SC1,2, Goldberg SI2, Kuhlthau KA3, Lawell MP2, Weyman EA2, Gallotto SL2, Hess CB2, Huang MS4, Friedmann AM4, Abrams AN5, MacDonald SM2, Pulsifer MB6, Tarbell NJ2, Ebb DH4, Yock TI2.
    1
    Harvard Radiation Oncology Program, Boston, Massachusetts.
    2
    Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.
    3
    Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts.
    4
    Department of Pediatric Oncology, Massachusetts General Hospital, Boston, Massachusetts.
    5
    Department of Child Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
    6
    Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.

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