Nonhemispheric Tumor Location, Female Sex, and Younger Age at Treatment are Independent Risk Factors of High-Grade Glioma

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(ChemotherapyAdvisor) – Persistent surveillance of children treated for high-grade glioma “is highly recommended as standard of care” to minimize late effects of treatment and ensure long-term survival, the first systematic investigation of neuropsychological functioning, behavior, and quality of life (QoL) in this population concluded in the Journal of Clinical Oncology published online February 21.

The Children's Oncology Group (COG) L991 study investigated outcomes of 54 patients (29 males, 25 females) enrolled at 25 institutions who represented 81% of available survivors. Median age at diagnosis was 8.8 years; median length of follow-up, 15.1 years; and median age at study evaluation, 23.6 years.

Standardized tests of neuropsychological functioning and QoL found intellectual functioning to be within the low-average range, while executive functioning and verbal memory were between the low-average and borderline ranges, and visual memory and psychomotor processing speed between the borderline and impaired ranges. For both physical and psychosocial domains, approximately 75% of patients reported overall QoL within or above normal limits.

Compared with males, females had significantly lower verbal intellectual abilities, lower physical QoL, and more depressive symptoms. Those younger than the age of 3 years at the time of treatment had significantly lower global intellectual abilities and nonverbal intelligence.

Independent risk factors were identified as nonhemispheric tumor location (midline or cerebellum), female sex, and younger age at treatment. The authors noted that these results can “serve as a benchmark for comparison with future pediatric high-grade glioma studies in addition to identifying at-risk cohorts that warrant further research and proactive interventions.”


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