Skip to main content
British Journal of Cancer logoLink to British Journal of Cancer
. 1997;76(5):643–650. doi: 10.1038/bjc.1997.439

School behaviour and health status after central nervous system tumours in childhood.

A W Glaser 1, N F Abdul Rashid 1, C L U 1, D A Walker 1
PMCID: PMC2228016  PMID: 9303365

Abstract

This study was designed to assess the overall morbidity burden of survival from central nervous system (CNS) tumours and its impact on return to a normal lifestyle. School behaviour and health status of 27 children after treatment for CNS tumours, of 25 of their school-aged siblings, plus age- and sex-matched controls is reported. Spinetta school behaviour, Lansky play-performance and Health Utilities Index (mark II and III) assessments have been made. Patients had reduced mobility and increased pain levels. They demonstrated a reluctance to participate in organized physical activities. Impaired cognition, emotion and self-esteem were reported. They worried more than controls but attended school willingly, interacted normally with their peers and viewed the future confidently. Their siblings were reluctant to express openly concern for others or feelings of joy. Teachers were reliable proxies for most attributes, notable exceptions being speech and emotion. This is the first study to have assessed the school behaviour of a cohort solely composed of survivors of childhood CNS tumours. The good social reintegration is reassuring and likely to reflect a high level of psychosocial support. However, the results presented identify these young people as a 'special educational needs' group as defined by the 1981 and 1993 Education Acts.

Full text

PDF
643

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen A., Malpas J. S., Kingston J. E. Educational achievements of survivors of childhood cancer. Pediatr Hematol Oncol. 1990;7(4):339–345. doi: 10.3109/08880019009033411. [DOI] [PubMed] [Google Scholar]
  2. Anderson V., Smibert E., Ekert H., Godber T. Intellectual, educational, and behavioural sequelae after cranial irradiation and chemotherapy. Arch Dis Child. 1994 Jun;70(6):476–483. doi: 10.1136/adc.70.6.476. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Ball W. S., Jr, Prenger E. C., Ballard E. T. Neurotoxicity of radio/chemotherapy in children: pathologic and MR correlation. AJNR Am J Neuroradiol. 1992 Mar-Apr;13(2):761–776. [PMC free article] [PubMed] [Google Scholar]
  4. Billson A. L., Walker D. A. Assessment of health status in survivors of cancer. Arch Dis Child. 1994 Mar;70(3):200–204. doi: 10.1136/adc.70.3.200. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Boyle M. H., Furlong W., Feeny D., Torrance G. W., Hatcher J. Reliability of the Health Utilities Index--Mark III used in the 1991 cycle 6 Canadian General Social Survey Health Questionnaire. Qual Life Res. 1995 Jun;4(3):249–257. doi: 10.1007/BF02260864. [DOI] [PubMed] [Google Scholar]
  6. Carr-Gregg M., White L. Siblings of paediatric cancer patients: a population at risk. Med Pediatr Oncol. 1987;15(2):62–68. doi: 10.1002/mpo.2950150204. [DOI] [PubMed] [Google Scholar]
  7. Charlton A., Larcombe I. J., Meller S. T., Morris Jones P. H., Mott M. G., Potton M. W., Tranmer M. D., Walker J. J. Absence from school related to cancer and other chronic conditions. Arch Dis Child. 1991 Oct;66(10):1217–1222. doi: 10.1136/adc.66.10.1217. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Duffner P. K., Cohen M. E., Voorhess M. L., MacGillivray M. H., Brecher M. L., Panahon A., Gilani B. B. Long-term effects of cranial irradiation on endocrine function in children with brain tumors. A prospective study. Cancer. 1985 Nov 1;56(9):2189–2193. doi: 10.1002/1097-0142(19851101)56:9<2189::aid-cncr2820560909>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  9. Eiser C. Cognitive deficits in children treated for leukaemia. Arch Dis Child. 1991 Jan;66(1):164–168. doi: 10.1136/adc.66.1.164. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Eiser C., Town C. Teachers' concerns about chronically sick children: implications for paediatricians. Dev Med Child Neurol. 1987 Feb;29(1):56–63. doi: 10.1111/j.1469-8749.1987.tb02107.x. [DOI] [PubMed] [Google Scholar]
  11. Ellenberg L., McComb J. G., Siegel S. E., Stowe S. Factors affecting intellectual outcome in pediatric brain tumor patients. Neurosurgery. 1987 Nov;21(5):638–644. doi: 10.1227/00006123-198711000-00006. [DOI] [PubMed] [Google Scholar]
  12. Fallowfield L. Quality of quality-of-life data. Lancet. 1996 Aug 17;348(9025):421–422. doi: 10.1016/S0140-6736(05)64534-5. [DOI] [PubMed] [Google Scholar]
  13. Feeny D., Furlong W., Boyle M., Torrance G. W. Multi-attribute health status classification systems. Health Utilities Index. Pharmacoeconomics. 1995 Jun;7(6):490–502. doi: 10.2165/00019053-199507060-00004. [DOI] [PubMed] [Google Scholar]
  14. Gamis A. S., Nesbit M. E. Neuropsychologic (cognitive) disabilities in long-term survivors of childhood cancer. Pediatrician. 1991;18(1):11–19. [PubMed] [Google Scholar]
  15. Gemke R. J., Bonsel G. J., van Vught A. J. Long-term survival and state of health after paediatric intensive care. Arch Dis Child. 1995 Sep;73(3):196–201. doi: 10.1136/adc.73.3.196. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Glaser A., Walker D. Quality of life. Lancet. 1995 Aug 12;346(8972):444–444. [PubMed] [Google Scholar]
  17. Glauser T. A., Packer R. J. Cognitive deficits in long-term survivors of childhood brain tumors. Childs Nerv Syst. 1991 Feb;7(1):2–12. doi: 10.1007/BF00263824. [DOI] [PubMed] [Google Scholar]
  18. Greenberg H. S., Kazak A. E., Meadows A. T. Psychologic functioning in 8- to 16-year-old cancer survivors and their parents. J Pediatr. 1989 Mar;114(3):488–493. doi: 10.1016/s0022-3476(89)80581-5. [DOI] [PubMed] [Google Scholar]
  19. Gregory K., Parker L., Craft A. W. Returning to primary school after treatment for cancer. Pediatr Hematol Oncol. 1994 Jan-Feb;11(1):105–109. doi: 10.3109/08880019409141907. [DOI] [PubMed] [Google Scholar]
  20. Havermans T., Eiser C. Siblings of a child with cancer. Child Care Health Dev. 1994 Sep-Oct;20(5):309–322. doi: 10.1111/j.1365-2214.1994.tb00393.x. [DOI] [PubMed] [Google Scholar]
  21. Jenney M. E., Kane R. L., Lurie N. Developing a measure of health outcomes in survivors of childhood cancer: a review of the issues. Med Pediatr Oncol. 1995 Mar;24(3):145–153. doi: 10.1002/mpo.2950240302. [DOI] [PubMed] [Google Scholar]
  22. Kanabar D. J., Attard-Montalto S., Saha V., Kingston J. E., Malpas J. E., Eden O. B. Quality of life in survivors of childhood cancer after megatherapy with autologous bone marrow rescue. Pediatr Hematol Oncol. 1995 Jan-Feb;12(1):29–36. doi: 10.3109/08880019509029525. [DOI] [PubMed] [Google Scholar]
  23. Kelaghan J., Myers M. H., Mulvihill J. J., Byrne J., Connelly R. R., Austin D. F., Strong L. C., Meigs J. W., Latourette H. B., Holmes G. F. Educational achievement of long-term survivors of childhood and adolescent cancer. Med Pediatr Oncol. 1988;16(5):320–326. doi: 10.1002/mpo.2950160506. [DOI] [PubMed] [Google Scholar]
  24. Kiltie A. E., Gattamaneni H. R. Survival and quality of life of paediatric intracranial germ cell tumour patients treated at the Christie Hospital, 1972-1993. Med Pediatr Oncol. 1995 Dec;25(6):450–456. doi: 10.1002/mpo.2950250606. [DOI] [PubMed] [Google Scholar]
  25. Landis J. R., Koch G. G. The measurement of observer agreement for categorical data. Biometrics. 1977 Mar;33(1):159–174. [PubMed] [Google Scholar]
  26. Lansky S. B., List M. A., Lansky L. L., Ritter-Sterr C., Miller D. R. The measurement of performance in childhood cancer patients. Cancer. 1987 Oct 1;60(7):1651–1656. doi: 10.1002/1097-0142(19871001)60:7<1651::aid-cncr2820600738>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  27. Larcombe I. J., Walker J., Charlton A., Meller S., Morris Jones P., Mott M. G. Impact of childhood cancer on return to normal schooling. BMJ. 1990 Jul 21;301(6744):169–171. doi: 10.1136/bmj.301.6744.169. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Livesey E. A., Hindmarsh P. C., Brook C. G., Whitton A. C., Bloom H. J., Tobias J. S., Godlee J. N., Britton J. Endocrine disorders following treatment of childhood brain tumours. Br J Cancer. 1990 Apr;61(4):622–625. doi: 10.1038/bjc.1990.138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Mancini A. F., Rosito P., Canino R., Calzetti G., Di Caro A., Salmi S., Bonsi S., Marchi N., Paolucci G., Missiroli G. School-related behavior in children with cancer. Pediatr Hematol Oncol. 1989;6(2):145–154. doi: 10.3109/08880018909034280. [DOI] [PubMed] [Google Scholar]
  30. Mulhern R. K., Heideman R. L., Khatib Z. A., Kovnar E. H., Sanford R. A., Kun L. E. Quality of survival among children treated for brain stem glioma. Pediatr Neurosurg. 1994;20(4):226–232. doi: 10.1159/000120795. [DOI] [PubMed] [Google Scholar]
  31. Mulhern R. K., Wasserman A. L., Friedman A. G., Fairclough D. Social competence and behavioral adjustment of children who are long-term survivors of cancer. Pediatrics. 1989 Jan;83(1):18–25. [PubMed] [Google Scholar]
  32. Pantell R. H., Lewis C. C. Measuring the impact of medical care on children. J Chronic Dis. 1987;40 (Suppl 1):99S–115S. doi: 10.1016/s0021-9681(87)80039-5. [DOI] [PubMed] [Google Scholar]
  33. Radcliffe J., Packer R. J., Atkins T. E., Bunin G. R., Schut L., Goldwein J. W., Sutton L. N. Three- and four-year cognitive outcome in children with noncortical brain tumors treated with whole-brain radiotherapy. Ann Neurol. 1992 Oct;32(4):551–554. doi: 10.1002/ana.410320411. [DOI] [PubMed] [Google Scholar]
  34. Saigal S., Rosenbaum P., Stoskopf B., Hoult L., Furlong W., Feeny D., Burrows E., Torrance G. Comprehensive assessment of the health status of extremely low birth weight children at eight years of age: comparison with a reference group. J Pediatr. 1994 Sep;125(3):411–417. doi: 10.1016/s0022-3476(05)83288-3. [DOI] [PubMed] [Google Scholar]
  35. Slavc I., Salchegger C., Hauer C., Urban C., Oberbauer R., Pakisch B., Ebner F., Schwinger W., Mokry M., Ranner G. Follow-up and quality of survival of 67 consecutive children with CNS tumors. Childs Nerv Syst. 1994 Sep;10(7):433–443. doi: 10.1007/BF00303608. [DOI] [PubMed] [Google Scholar]
  36. Torrance G. W., Boyle M. H., Horwood S. P. Application of multi-attribute utility theory to measure social preferences for health states. Oper Res. 1982 Nov-Dec;30(6):1043–1069. doi: 10.1287/opre.30.6.1043. [DOI] [PubMed] [Google Scholar]
  37. Torrance G. W., Furlong W., Feeny D., Boyle M. Multi-attribute preference functions. Health Utilities Index. Pharmacoeconomics. 1995 Jun;7(6):503–520. doi: 10.2165/00019053-199507060-00005. [DOI] [PubMed] [Google Scholar]
  38. Ware J. E., Jr, Brook R. H., Davies A. R., Lohr K. N. Choosing measures of health status for individuals in general populations. Am J Public Health. 1981 Jun;71(6):620–625. doi: 10.2105/ajph.71.6.620. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES