QOS-15: QUALITY OF LIFE OUTCOMES IN CHILDREN WITH PILOCYTIC ASTROCYTOMAS: A CROSS-SECTIONAL STUDY

Pilocytic astrocytomas (PAs) are low grade gliomas with 10 year overall survival rates of more than 95%. The study objective was to assess the quality of life (QOL) outcomes in children with PAs and review the impact of clinical characteristics and treatment modalities on QOL. A cross-sectional survey was conducted using the PedsQL^TM 4.0 generic core scales and the PedsQL^TM cognitive functioning scale child and parent report forms. Of 46 children (5-18 years) diagnosed between1999-2013, 29 (63%) patients (17 female) and 30 (65.2%) parents completed the surveys. Median age at diagnosis was 3.8 years (range = 1.1-14.7 years). Median duration from diagnosis to QOL assessment was 7.8 years (range = 1.5-16.1 years). Tumor sites included deep/midline (n = 15), cerebellum (n = 13), and cerebrum (n = 2). Eleven (36.7%) patients had recurrence/progression. One patient had disseminated disease. Treatment included surgery [n = 27; 1 resection: n = 23, multiple resections: n = 4), and/or radiation/chemotherapy (n = 6)]. Mean total score for patient self-report (81.6 ± 12.9) was similar in comparison to a reference healthy population (83 ± 14.79). Moderate to very strong correlation was observed between self and parent reports for all scales except the emotional functioning scale. No significant association was noted between age, sex, recurrence status, tumor site, degree of resection or receiving chemotherapy/radiation therapy and total scores. Female gender was associated with lower emotional functioning score (p = 0.027). Post-operative neurologic worsening was associated with lower total (p = 0.009), physical (p < 0.001) and emotional functioning scores (p = 0.034). Given the excellent long term prognosis, risk of therapy-related neurologic deficits and its impact on QOL should be an important consideration in treatment decisions.