ID #557 Head Start 4 (HS4): Baseline neurocognitive, quality of life, executive, social-emotional, behavioral, and adaptive functioning
Stephanie Steinberg, Elizabeth Malkin, Sameera Ramjan, Parth Patel, Megan Blue, Jonathan Finlay, GIrish Dhall, Stephen SandsAbstract
Introduction
Pediatric medulloblastoma patients are at increased risk for neurocognitive, social-emotional, behavioral and adaptive difficulties contributing to reduced quality of life (QoL).
Methods
N = 159 patients with medulloblastoma (median age=46 months, male=108, supratentorial=29, High-Risk=126) were recruited across 36 sites. Patients completed IQ assessment, while parents completed questionnaires for QoL, executive, social-emotional, behavioral, and adaptive functioning post 3- or 5-induction chemotherapy cycles but before consolidation chemotherapy and autologous stem cell transplant. Descriptive statistics and independent-samples t-tests to explore impacts of variables (age, sex, risk group) were run in RStudio.
Results
At baseline, overall intellectual, executive, adaptive, and social-emotional, behavioral functioning and working memory, are within the lower limits of the average range. In contrast, processing speed and overall QoL, including physical, emotional, school, and social, are below normal limits. Additionally, IQ, executive functioning, adaptive skills, and QoL were not significantly different based upon age, sex, or low- and high-risk diagnosis. Parent-rated externalizing problems were significantly higher for males (p = 0.03) and internalizing problems were significantly higher for the group 3 and 4 patients (p = 0.05). Parent-reported psychological distress did not differ by sex or tumor risk; however, was significantly higher for children above the median age (p = 0.04).
Conclusions
These HS4 medulloblastoma patients are performing within the average range of intelligence, working memory, executive functioning, social-emotional and behavioral functioning, while processing speed and adaptive functioning are within the low average range, and QoL is significantly impacted at baseline. Parent-reported psychological distress differed by child age, while males and high-risk patients were rated with increased social-emotional and behavioral symptoms, providing cohorts for proactive interventions. These consortium data demonstrate the feasibility to collect a comprehensive baseline for a young pediatric brain tumor population, from which to compare change at ongoing 2-, 4- and 6-year follow-up on this clinical and molecular risk-tailored regimen.