Social attainment in survivors of pediatric central nervous system (CNS) tumors: a systematic review and meta-analysis from the Children's Oncology Group (COG) Psychology Task Force on long-term follow-up (LTFU) guidelines [presentation] Presentation uri icon
Overview
abstract
  • Background/Purpose: CNS tumor survivors are at risk for late effects including social attainment (i.e., education, employment, relationships). A meta-analysis was conducted for modifications to the COG LTFU Guidelines (version 5.0) for social attainment in pediatric CNS tumor survivors compared to controls. Methods: Search terms were entered in four databases (PubMed, PsycINFO, EMBASE, Web of Science) yielding 5,694 articles published January 2011-August 2017. Articles were reviewed independently using the following inclusion criteria: 1) published in English; 2) diagnosis of CNS tumor between 0-21 years; 3) 5 years from diagnosis and/or 2 years from therapy completion; 4) reported social attainment outcomes; 5) original studies. Forty-one published studies were included. Bias assessments were completed for each study using the Cochrane Risk of Bias Tool. Random-effects meta-analyses were performed for binary outcomes (yes/no) using Review Manager 5.0. Results: Of 41 studies, 41% were low-risk of bias for selection/subject bias, 80% were low-risk for instrumentation/missing outcomes, and 66% were low-risk for reporting outcomes. Few studies (7%) included data for assessing attrition bias. Meta-analyses revealed poorer social attainment for CNS tumor survivors compared to healthy controls including: less likely to graduate college (OR 2.02, 95%CI 1.63-2.49), less likely to be married (OR 4.70, 95%CI 3.92-5.65), more likely to be unemployed (OR 2.63, 95%CI 1.74-3.97). Cranial radiation, younger age at diagnosis, and neurocognitive impairment were associated with poorer social attainment. Conclusions: Results of this work confirm the current guidelines (version 4.0). Future work should examine the unique contribution of CNS subtypes to social attainment outcomes.

  • Research
    keywords
  • Cancer
  • Disabilities
  • Nervous System Diseases
  • Pediatrics
  • Socioeconomic Factors
  • Survivors