Risk factors for neurocognitive impairment, emotional distress, and poor quality of life in survivors of pediatric rhabdomyosarcoma: A report from the Childhood Cancer Survivor Study

AI Summary

This study examines the risk factors for neurocognitive impairment, emotional distress, and poor quality of life in survivors of pediatric rhabdomyosarcoma. Results indicate that survivors are more likely to report impairment in various areas compared to siblings, with factors such as cranial, chest, and pelvic radiation, smoking, and chronic medical conditions contributing to increased risks. The findings suggest that improving local control therapies, promoting smoking cessation, and effectively managing chronic conditions could help mitigate the negative outcomes experienced by survivors of rhabdomyosarcoma.

Abstract

Background

Prevalence and risk of poor psychological outcomes following rhabdomyosarcoma (RMS) are not well-established.

Methods

Participants in this cross-sectional, case-control study (n = 713 survivors, 42.5% female; mean [SD] age, 30.5 [6.6] years; n = 706 siblings, 57.2% female; mean age, 32.8,[7.9] years) completed measures of neurocognition, emotional distress, and health-related quality of life (HRQOL). Multivariable logistic regression models identified treatments, health behaviors, and chronic conditions associated with impairment.

Results

Relative to siblings, more survivors reported neurocognitive impairment (task efficiency: 21.1% vs. 13.7%, emotional regulation: 16.7% vs. 11.0%, memory: 19.3% vs. 15.1%), elevated emotional distress (somatic distress: 12.9% vs. 4.7%, anxiety: 11.7% vs. 5.9%, depression: 22.8% vs. 16.9%) and poorer HRQOL (physical functioning: 11.1% vs. 2.8%, role functioning due to physical problems: 16.8% vs. 8.2%, pain: 17.5% vs. 10.0%, vitality: 22.3% vs. 13.8%, social functioning: 14.4% vs. 6.8%, emotional functioning: 17.1% vs. 10.6%). Cranial radiation increased risk for impaired task efficiency (odds ratio [OR], 2.30; 95% confidence interval [CI], 1.14–4.63), whereas chest and pelvic radiation predicted increased risk of physical functioning (OR, 2.68; 95% CI, 1.16–6.21 and OR, 3.44; 95% CI, 1.70–6.95, respectively). Smoking was associated with impaired task efficiency (OR, 2.06; 95% CI, 1.14–3.70), memory (OR, 2.23; 95% CI, 1.26–3.95), anxiety (OR, 2.71; 95% CI, 1.36–5.41) and depression (OR, 1.77; 95% CI, 1.01–3.11). Neurologic conditions increased risk of anxiety (OR, 2.30; 95% CI, 1.04–5.10), and hearing conditions increased risk of depression (OR, 1.79; 95% CI, 1.05–3.03). Neurologic and hearing conditions, respectively, were associated with impaired memory (OR, 2.44; 95% CI, 1.20–4.95 and OR, 1.87; 95% CI, 1.05–3.35) and poor health perception (OR, 2.62; 95% CI, 1.62–1.28 and OR, 2.33; 95% CI, 1.34–4.06).

Conclusions

RMS survivors are at significant risk for poor psychological outcomes. Advancing therapies for local control, smoking cessation, and managing chronic medical conditions may mitigate poor outcomes following RMS.