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Neurocognitive function, performance status, and quality of life in pediatric intracranial germ cell tumor survivors

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Abstract

Background

Intracranial germ cell tumors (GCT) are more common in Asia than in the West, accounting for about 15% of brain tumors in Asian children. The survival rate for intracranial GCT is excellent, but there are concerns about the effects of radiotherapy on neuropsychological function and quality of life of patients.

Methods

Intracranial germ cell tumors (GCT) are more common in Asia than in the West, accounting for about 15% of brain tumors in Asian children. The survival rate for intracranial GCT is excellent, but there are concerns about the effects of radiotherapy on neuropsychological function and quality of life of patients. Intracranial GCT survivors in Hong Kong aged ≥ 6 years who received cranial irradiation in the past 15 years were recruited. Neurocognitive function and performance status were assessed by the Hong Kong Wechsler Intelligence scale and Karnofsky/Lansky performance scales (KPS), respectively. Quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales. A chart review was performed for tumor characteristics and complications related to the tumor and its treatment.

Results

Twenty-five intracranial GCT survivors were recruited. Longer length of time since treatment was associated with lower IQ scores. Larger tumor size was associated with lower KPS scores. Hemiparesis, poor manual dexterity, and complications with multi-organ involvement were associated with significantly lower KPS scores. Higher irradiation dosage was associated with lower PedsQL physical scores.

Conclusions

The majority of GCT survivors had average intellectual functioning, satisfactory performance status and relatively good quality of life, except in the physical aspect. Comprehensive evaluation and long-term follow-up of GCT survivors are essential to provide timely support and improve long-term outcomes.

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Acknowledgements

The authors thank Hong Kong Research Grants Council for supporting this study. Dr P Ip and Prof GCF are co-corresponding authors of this paper.

Funding

This study was funded by Hong Kong Research Grants Council General Research Fund (Grant Number 17118815).

Author information

Author notes

  1. Winnie Wan Yee Tso and Anthony Pak Yin Liu are co-first authors.

Authors and Affiliations

  1. Department of Paediatrics & Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine, University of Hong Kong, 1/F New Clinical Building, 102 Pokfulam Road, Pokfulam, Hong Kong

    Winnie Wan Yee Tso, Anthony Pak Yin Liu, Ka Leung Cheuk, Ada Wing Yan Yung, Cheuk Wing Fung, Sophelia Hoi Shan Chan, Alvin Chi Chung Ho, Frederick Ka Wing Ho, Patrick Ip & Godfrey Chi Fung Chan

  2. State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong

    Tatia Mei Chun Lee

  3. Laboratory of Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong

    Tatia Mei Chun Lee

  4. Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Pokfulam, Hong Kong

    Ming Kong Shing

  5. Department of Paediatrics, Queen Elizabeth Hospital, Kowloon, Hong Kong

    Chung Wing Luk

  6. Department of Paediatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong

    Siu Cheung Ling

  7. Department of Paediatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong

    Dennis Tak Loi Ku

  8. Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong

    Kenneth Li

Authors
  1. Winnie Wan Yee Tso
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  2. Anthony Pak Yin Liu
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  9. Kenneth Li
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  14. Frederick Ka Wing Ho
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  15. Patrick Ip
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  16. Godfrey Chi Fung Chan
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Contributions

Tso designed the study, interpreted the data, and drafted the manuscript. Liu, Lee, Kwong, Cheuk, Shing, Luk, Ling, Ku, Li, Yung, Fung, SHS Chan, and ACC Ho interpreted the data and critically revised the manuscript. Ho analyzed the data and critically revised the manuscript. Ip and GCF Chan assisted study design, interpreted the data, and critically revised the manuscript.

Corresponding authors

Correspondence to Patrick Ip or Godfrey Chi Fung Chan.

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Conflict of interest

The authors declared no conflicts of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Tso, W.W.Y., Liu, A.P.Y., Lee, T.M.C. et al. Neurocognitive function, performance status, and quality of life in pediatric intracranial germ cell tumor survivors. J Neurooncol 141, 393–401 (2019). https://doi.org/10.1007/s11060-018-03045-3

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  • DOI: https://doi.org/10.1007/s11060-018-03045-3

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