Executive dysfunction is associated with poorer health-related quality of life in pediatric brain tumor survivors.
Executive dysfunction is associated with poorer health-related quality of life in pediatric brain tumor survivors.
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DOI：
10.1007/s11060-016-2113-1
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发表时间：
2016-06
影响因子：
3.9
通讯作者：
Conklin HM
中科院分区：
文献类型：
--
作者：
Netson KL;Ashford JM;Skinner T;Carty L;Wu S;Merchant TE;Conklin HM
患有脑肿瘤 (BT) 的儿童面临许多身体和认知问题的风险，这些问题可能会降低他们的健康相关生活质量 (HRQoL)。假设执行功能 (EF) 和智力能力与 HRQoL 相关，并且这些领域的缺陷可能需要干预。旨在调查儿童 BT 适形放射治疗 (CRT) 后的智力功能、EF 和 HRQoL。接受 CRT 治疗的 45 名 BT 幸存者（年龄 12.68±2.56）参与其中。 36 名 BT 患者的兄弟姐妹（年龄 12.36±2.13）和 33 名非 CNS 实体瘤幸存者（ST；年龄 12.18±2.88）为对照组。获得了 IQ 估计（韦氏智力简写量表；WASI）、EF 评级（执行功能行为评级清单；BRIEF）和 HRQoL 评级（KINDL-R）。 BT 幸存者报告的总体 HRQoL 低于 ST 幸存者 (p=.012)。父母报告的 BT 幸存者的总体 HRQoL 低于兄弟姐妹 (p=.014)。对于大多数分量表，家长报告的 HRQoL 个别领域高于自我报告。 IQ 和 HRQoL 评级不相关（父母 r=.17，p=.27；儿童 r=.11，p=.49）。 EF 评级与父母相关（r=-.15 至 -.73），但与儿童 HRQoL 评级无关。患有 BT 的儿童的 HRQoL 低于对照组。在所有领域，家长对儿童 HRQoL 的评价始终高于自我报告。 HRQoL 与 EF 相关，但与 IQ 无关。这些发现确定了针对 EF 的干预措施（例如认知康复、药物治疗）是改善儿童 BT 幸存者 HRQoL 的可能途径。
Children with brain tumor (BT) are at risk for a number of physical and cognitive problems that may lower their health-related quality of life (HRQoL). Executive functioning (EF) and intellectual ability are hypothesized to associate with HRQoL and deficits in these areas may be amenable to interventions. To investigate intellectual function, EF, and HRQoL following conformal radiation therapy (CRT) for pediatric BT. Forty-five BT survivors (age 12.68±2.56) treated with CRT participated. Thirty-six siblings of BT patients (age 12.36±2.13) and 33 survivors of non-CNS solid tumors (ST; age 12.18±2.88) were comparison groups. IQ estimate (Wechsler Abbreviated Scale of Intelligence; WASI), EF ratings (Behavior Rating Inventory of Executive Function; BRIEF), and HRQoL ratings (KINDL-R) were obtained. BT survivors reported lower overall HRQoL than ST survivors (p=.012). Parents reported lower overall HRQoL for BT survivors than siblings (p=.014). Parent-report on individual areas of HRQoL was higher than self-report for most subscales. IQ and HRQoL ratings were not related (Parent r=.17, p=.27; Child r=.11, p=.49). EF ratings correlated with Parent (r=-.15 to -.73) but not Child HRQoL ratings. Children with BT experienced poorer HRQoL than controls. Children's HRQoL was consistently rated higher by parent- than self-report across all domains. HRQoL was associated with EF, but not with IQ. These findings identify interventions targeting EF (e.g., cognitive rehabilitation, medication) as a possible avenue for improving HRQoL in childhood BT survivors.