Peer-reviewed article
Social attainment in survivors of pediatric central nervous system tumors: a systematic review and meta-analysis from the Children's Oncology Group.
Fiona Schulte, Alicia S Kunin-Batson, Barbara A Olson-Bullis, Pia Banerjee, Matthew C Hocking et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review examines long-term social outcomes for children who survived brain and spinal cord tumors. Compared to children without cancer, survivors were significantly less likely to complete higher education, get married, or find employment. The poorest outcomes were associated with radiation therapy to the head, cognitive problems, and sensory loss. The review calls for interventions to help these young survivors transition to independent adult lives.
Key points
- Survivors of pediatric CNS tumors were 1.87 times more likely to have completed only compulsory education compared to non-cancer controls
- Survivors were 4.70 times less likely to be married
- Survivors were 2.84 times more likely to be unemployed
- Cranial radiation therapy, neurocognitive deficits, and younger age at diagnosis were associated with poorer outcomes
- Hearing loss and bilateral blindness were also related to worse social attainment outcomes
Limitations
The review does not specify which countries' data were included, limiting understanding of how healthcare systems and social support structures may affect outcomes. The review synthesizes studies published 2011-2018, so more recent evidence of interventions supporting survivors' social development is not captured.
Abstract
PURPOSE: Improved therapies for pediatric central nervous system (CNS) tumors have increased survival rates; however, many survivors experience significant long-term functional limitations. Survivors of pediatric CNS tumors can experience deficits in social attainment. The aim of this review was to systematically amalgamate findings pertaining to social attainment (i.e., educational attainment, marriage, employment outcomes) in survivors of pediatric CNS tumors. METHODS: PubMed (web-based), PsycINFO (EBSCO), EMBASE (Ovid), and Web of Science (Thomson Reuters) were used to identify articles published between January 2011 and September 2018. Eligible studies reported outcomes for survivors of pediatric CNS tumors diagnosed before age 21 years and > 5 years from diagnosis and/or > 2 years off therapy. All data were independently abstracted by two reviewers. Random-effects meta-analyses were performed using Review Manager 5.0. RESULTS: The search yielded 7021 unique publications. Forty-six were included in the current review. Meta-analyses revealed survivors of CNS tumors were significantly more likely to have completed compulsory education only (OR = 1.87, 95% CI = 1.66, 2.12, p < 0.00001), less likely to be married (OR = 4.70, 95% CI = 3.89, 5.68, p < 0.00001), and more likely to be unemployed (OR = 2.84, 95% CI = 2.62, 3.08, p < 0.00001) compared to non-cancer controls. Cranial radiation therapy, neurocognitive deficits, and younger age at diagnosis were associated with poorer outcomes. Hearing loss and bilateral blindness were also related to poorer outcomes. Sex did not impact social attainment outcomes. CONCLUSIONS: Survivors of pediatric CNS tumors are at elevated risk for poor attainment of key adult social outcomes. IMPLICATIONS FOR CANCER SURVIVORS: There is a critical need to develop interventions to support survivors in becoming independent and productive adults.