Memory impairment and neurocognitive deficits reduce the health-related quality of life in medulloblastoma survivors
Bibliographic record
Abstract
Background Survivors of childhood medulloblastoma are particularly susceptible to late effects because of the location of the tumour and the treatment required to achieve a cure. Living with these long-term toxicities is challenging and greater understanding of the impact of the disease and treatment have on health-related quality of life (HRQoL) is needed. Procedure We report a cross-sectional study to assess patient HRQoL outcomes for 52 long-term survivors of medulloblastoma aged 1–25 years of age at diagnosis and treated during a ten-year period at The Royal Marsden Hospital. Child self-reports and parent – proxy reports of PedsQL scores correlate with clinical information, long-term toxicity (assessed using CTCAE) and neurocognitive assessment (using WISC-IV) to examine the impact that disease and treatment have on HRQoL after treatment. Results Reported late toxicities included ataxia (62%), hearing impairment (59%), endocrine disorders (57%) and memory impairment (44%). Reduced HRQoL outcome scores for patients showed a significant correlation with reduced verbal comprehension (0.51; p=0.025), and processing speed (0.5; p=0.04). Memory impairment showed significant association with the cancer module PedsQL (p=0.024) scores. Parents’ perception of their child’s quality of life was lower than the patient’s self-assessment (mean 55.9 for parents and 63.8 for patients, p=0.004). Conclusions The findings from this study confirm the impact of late toxicities and neurocognitive sequelae on HRQoL in patients previously treated for medulloblastoma in childhood and adolescence. In particular verbal comprehension, processing speed and memory impairment influence patient reported outcomes in this cohort.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".