Health-Related Quality of Life, Activities of Daily Living and Parenting Stress in Children with Brain Tumors

OBJECTIVE: To compare health-related quality of life (HRQOL), activities of daily living (ADL), and parenting stress between children with brain tumors and those of normal control (NC). METHODS: Participants were 31 brain tumor patients who had received chemotherapy, radiotherapy, or peripheral blood stem cell transplantation after surgical resection and 125 NC subjects. We administered the Pediatric Quality of Life Inventory, version 4.0 (PedsQL), to assess HRQOL; the Korean version of the Parenting Stress Index-Short Form (K-PSI-SF), to assess parenting stress; and examined ADL. RESULTS: The mean self-report PedsQL scores for physical health, emotional functioning, social functioning, school functioning, and total scores in the patients were significantly lower than those of the NC group. The mean parent proxy-report PedsQL scores for all scales except emotional functioning in the patient group were significantly lower than those of the NC group. The ADL impairment for the patients was significantly more than that of the NC group. The K-PSI-SF mean scores for stress related to having a difficult child and for stress related to parent-child interaction in the patient group tended to be higher than those of the NC group (p=0.09). CONCLUSION: The children with brain tumors had lower HRQOL and difficulties in performing ADL. The parents of children with brain tumors tended to experience stress related to having a difficult child and to parent-child interaction. We suggest that long-term monitors for the child's HRQOL and ADL, and parenting stress in children with brain tumors are needed.

Factors Affecting the Increments of Body Mass Index in Adult Survivors of Childhood Brain Tumors / 소아과

PURPOSE: The purpose of this study was to evaluate the factors affecting the increments of body mass index(BMI) in adult survivors from childhood brain tumors. METHODS: We retrospectively reviewed medical records of 63 patients who were diagnosed with brain tumors and treated at Seoul National University Children's Hospital between 1982 and 2000. We evaluated the factors affecting adult BMI(aBMI) at attainment of final adult height(FAH). Observed factors were as follows : characteristics of tumors, modes of treatment for tumors, existence of growth hormone deficiency(GHD) and growth hormone(GH) replacements, cumulative BMI changes according to GH replacements. RESULTS: aBMI in patients with GHD was greater than that in patients without GHD(23.5+/-3.9 kg/ m2 vs 20.4+/-2.8 kg/m2, P=0.012). Among patients with GHD, GH replacement didn't make any difference in aBMI between treated and untreated patients. Cumulative BMI changes from diagnosis of tumor to attainment of FAH( BMI) were positively correlated with cumulative BMI changes before and during GH replacement(r=0.740, P<0.001 and r=0.574, P<0.001, respectively). When analyzed by multiple stepwise linear regression, the strongest related factor for increment of BMI was the increment of cumulative BMI changes before GH replacements. BMI increments velocity(cumulative BMI change/year) before and during GH replacements were 2.3+/-2.5 kg/m2/year and 0.9+/-1.6 kg/m2/ year, respectively(P=0.005). Patients with extensive surgery were greater aBMI(P=0.036). CONCLUSION: This study suggests that GHD and damage of hypothalamus by tumor and/or modes of treatment contribute to the increment of BMI in adult survivors of childhood brain tumors. Early GH replacements may possibly prevent severe hypothalamic obesity, which should be further clarified.