Systematic review and meta‐analysis of health‐related quality of life in pediatric CNS tumor survivors

• Published in: Pediatric blood & cancer 2017-08, Vol.64 (8), p.n/a
• Main Authors: Schulte, Fiona, Russell, K. Brooke, Cullen, Patricia, Embry, Leanne, Fay‐McClymont, Taryn, Johnston, Donna, Rosenberg, Abby R., Sung, Lillian
• Format: Article
• Language: English
• Subjects: Age; Cancer; Central nervous system; Central Nervous System Neoplasms - complications; Child; CNS tumors; Female; Health risks; Health Status; Hematology; Humans; late effects of cancer treatment; Male; Meta-analysis; Oncology; pediatric oncology; Pediatrics; psychosocial; Quality of Life; Reviews; Survivors; Systematic review
• ISSN: 1545-5009; 1545-5017
• DOI: 10.1002/pbc.26442

Background Pediatric central nervous system (CNS) tumor survivors are at high risk for numerous late effects including decreased health‐related quality of life (HRQOL). Our objective was to summarize studies describing HRQOL in pediatric CNS tumor survivors and compare HRQOL outcomes in studies that included a comparison group. Procedure EMBASE, MEDLINE, and PsychINFO were used to identify relevant articles published until August, 2016. Eligible studies reported outcomes for pediatric CNS tumor survivors diagnosed before age 21, at least 5 years from diagnosis and/or 2 years off therapy and used a standardized measure of HRQOL. All data were ed by two reviewers. Random‐effects meta‐analyses were performed using Review Manager 5.0. Results Of 1,912 unique articles identified, 74 were included in this review. Papers described 29 different HRQOL tools. Meta‐analyses compared pediatric CNS tumor survivors to healthy comparisons and other pediatric cancer survivors separately. HRQOL was significantly lower for CNS (n = 797) than healthy comparisons (n = 1,397) (mean difference = –0.54, 95% confidence interval [CI] = –0.72 to –0.35, P < 0.001, I2 = 35%). HRQOL was also significantly lower for CNS (n = 244) than non‐CNS survivors (n = 414) (mean difference = –0.56, 95% CI = –0.73 to –0.38, P < 0.00001, I2 = 0%). Conclusions Pediatric CNS tumor survivors experience worse HRQOL than healthy comparisons and non‐CNS cancer survivors. Future HRQOL work should be longitudinal, and/or multisite studies that examine HRQOL by diagnosis and treatment modalities.