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Treatment,
Age, and Time-Related Predictors of Behavioral Outcome in Pediatric Brain Tumor
Survivors
Lori
A. Holmquist, Jim Scott
Department
of Psychiatry and Behavioral Sciences, Oklahoma University Health Sciences
Center, Oklahoma City, Oklahoma
The
research has shown that children surviving cancer
are at risk for long-term emotional and
behavioral problems secondary to the cumulative effects of cranial irradiation
and chemotherapy.
The purpose of this study was to investigate the emotional and behavioral
outcome of children diagnosed with brain tumor
and treated with cranial irradiation and chemotherapy by looking at the
association between treatment, time, age, and cognitive-related variables on
externalizing and internalizing behaviors at 3 years posttreatment.
Fifty-four brain tumor
survivors were administered a neuropsychological test battery, whereas the parents
filled out the CBCL and Conners' Parent
Rating Scale.
The results indicate that chemotherapy treatment with vincristine, cytoxan,
cisplantinum, and/or VP16 was related to poorer internalizing and externalizing
behavioral outcome, especially attention, social withdrawal, and anxious–depressive
symptomatology.
Age at time of diagnosis or treatment, time since discontinuation of treatment,
type and/or total dose of radiation therapy was not significantly correlated
with any of the behavioral outcome scales.
Verbal memory and learning deficits accounted for a significant portion of the
variance in social withdrawal, whereas lower scores in overall intellectual
functioning and verbal fluency was related to disturbances in attention,
inhibition, and social functioning.
The findings suggest that children treated with 1 or a combination of any of the
aforementioned chemotherapy agents who exhibit declines in intellectual
functioning and memory are at increased risk
for long-term behavioral problems 3 years after treatment cessation.
These findings support the importance for early psychotherapeutic and supportive
intervention services immediately after treatment cessation, with the goal of
circumventing these potentially debilitating emotional problems.
Keywords:
pediatric cancer, behavioral outcome,
predictors of behavioral outcome, brain tumor
Copyright
©
2002 Plenum Publishing Corporation.
All rights reserved
Source: http://journals.kluweronline.com/article.asp?PIPS=453255
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