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Parent-reported social outcomes after treatment for pediatric embryonal tumors: a prospective longitudinal study
Tara M Brinkman1, Shawna L Palmer, Si Chen
1St Jude Children's Research Hospital, Department of Epidemiology and Cancer Control, 262 Danny Thomas Place, MS 735, Memphis, TN 38105, USA. tara.brinkman@stjude.org
Insights
Pediatric embryonal brain tumor survivors generally show positive social adjustment long-term. However, high-risk treatment and posterior fossa syndrome can negatively impact social functioning, requiring further study.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Child Psychology
Background:
- Pediatric embryonal brain tumors (PEBTs) are aggressive central nervous system malignancies.
- Long-term social outcomes for survivors are crucial for quality of life.
- Understanding factors influencing social adjustment is essential for comprehensive care.
Purpose of the Study:
- To longitudinally examine parent-reported social outcomes in children treated for PEBTs.
- To identify demographic and treatment-related factors associated with social functioning changes.
Main Methods:
- A cohort of 220 patients treated on a multisite clinical protocol.
- Longitudinal data collection using the Child Behavior Checklist/6-18.
- Generalized linear mixed effects models to analyze changes in social competence, problems, and withdrawn/depressed behaviors.
Main Results:
- Most patients reported average social functioning scores within 5 years post-treatment.
- High-risk treatment status correlated with increased social problems and withdrawn/depressed behaviors.
- Posterior fossa syndrome, female sex, and lower intelligence predicted poorer social outcomes.
Conclusions:
- Children treated for PEBTs generally exhibit positive social adjustment.
- Treatment risk status and posterior fossa syndrome are significant predictors of long-term social outcomes.
- Further research is needed to understand social functioning trajectories into adulthood.
Purpose:
To examine longitudinal parent-reported social outcomes for children treated for pediatric embryonal brain tumors.
Patients And Methods:
Patients (N=220) were enrolled onto a multisite clinical treatment protocol. Parents completed the Child Behavior Checklist/6-18 at the time of their child's diagnosis and yearly thereafter. A generalized linear mixed effects model regression approach was used to examine longitudinal changes in parent ratings of social competence, social problems, and withdrawn/depressed behaviors with demographic and treatment factors as covariates.
Results:
During the 5-year period following diagnosis and treatment, few patients were reported to have clinically elevated scores on measures of social functioning. Mean scores differed significantly from population norms, yet remained within the average range. Several factors associated with unfavorable patterns of change in social functioning were identified. Patients with high-risk treatment status had a greater increase in parent-reported social problems (P=.001) and withdrawn/depressed behaviors (P=.01) over time compared with average-risk patients. Patients with posterior fossa syndrome had greater parent-reported social problems over time (P=.03). Female patients showed higher withdrawn/depressed scores over time compared with male patients (P<.001). Patient intelligence, age at diagnosis, and parent education level also contributed to parent report of social functioning.
Conclusion:
Results of this study largely suggest positive social adjustment several years after diagnosis and treatment of a pediatric embryonal tumor. However, several factors, including treatment risk status and posterior fossa syndrome, may be important precursors of long-term social outcomes. Future research is needed to elucidate the trajectory of social functioning as these patients transition into adulthood.
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