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Neurobehavioral Impairment in Pediatric Brain Tumor Survivors: A Meta-Analysis
Yuliang Wang1, Anthony Pak Yin Liu1,2, Tatia Mei-Chun Lee3,4
1Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China.
Insights
Pediatric brain tumor survivors face increased risks of emotional, psychosocial, and attention problems. Regular neurobehavioral monitoring is recommended for these individuals.
Area of Science:
- Neuroscience
- Pediatric Oncology
- Psychology
Background:
- Neurocognitive outcomes in pediatric brain tumor survivors (PBTS) are studied, but neurobehavioral impairment risks are less defined.
- Understanding emotional, psychosocial, and attention issues is crucial for long-term survivor care.
Purpose of the Study:
- To systematically analyze the rates and predictors of emotional, psychosocial, and attention problems in PBTS.
- To quantify the risk of neurobehavioral impairment in this population.
Main Methods:
- Systematic literature search of major databases (PubMed, Web of Science, Embase, Scopus, Cochrane) from 2012 to 2022.
- Inclusion of studies reporting neurobehavioral outcomes for PBTS aged 2 to <23 years.
- Random-effect meta-analysis to synthesize findings.
Main Results:
- The estimated risks for emotional, psychosocial, and attention problems were 15%, 12%, and 12%, respectively.
- PBTS showed significantly higher rates of emotional, psychosocial, and attention difficulties compared to healthy controls.
- No significant difference in neurobehavioral impairment was found between survivors with or without cranial radiotherapy history.
Conclusions:
- PBTS are at an elevated risk for neurobehavioral impairment.
- Neurobehavioral monitoring should be integrated into the standard care for PBTS.
- Further research may explore specific predictors and interventions.
Abstract:
Purpose: The neurocognitive outcomes of pediatric brain tumor survivors have been extensively studied but the risk and predictors for neurobehavioral impairment are less clearly defined. We systematically analyzed the rates of emotional, psychosocial, and attention problems in pediatric brain tumor survivors. Methods: PubMed, Web of Science, Embase, Scopus, and Cochrane were searched for articles published between January 2012 to April 2022. Eligible studies reported neurobehavioral outcomes for PBTS aged 2 to <23 years with a brain tumor diagnosis before 18 years of age. A random-effect meta-analysis was performed in R. Results: The search yielded 1187 unique publications, of which 50 were included in the quantitative analysis. The estimated risk of having emotional, psychosocial, and attention problems were 15% (95%CI 10−20%), 12% (95%CI 9−16%), and 12% (95%CI 9−16%), respectively. PBTS were more likely to have emotional difficulties (Hedge’s g = 0.43 [95%CI 0.34−0.52]), psychosocial problems (Hedge’s g = 0.46 [95%CI 0.33−0.58]), and attention problems (Hedge’s g = 0.48 [95%CI 0.34−0.63]) compared to normal/healthy control subjects. There was no significant difference in the rates of neurobehavioral impairment between children with and without history of cranial radiotherapy. Conclusions: PBTS are at elevated risk of neurobehavioral impairment. Neurobehavioral monitoring should be considered as the standard of care for PBTS.
