Published online November 1, 2007
PEDIATRICS Vol. 120 No. 5 November 2007, pp. e1229-e1236 (doi:10.1542/peds.2007-0178)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gurney, J. G.
Right arrow Articles by Schmidt, M. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gurney, J. G.
Right arrow Articles by Schmidt, M. L.
Related Collections
Right arrow Tumors

ARTICLE

Hearing Loss, Quality of Life, and Academic Problems in Long-term Neuroblastoma Survivors: A Report From the Children's Oncology Group

James G. Gurney, PhDa, Jean M. Tersak, MDb, Kirsten K. Ness, PhDc, Wendy Landier, RN, MSNd, Katherine K. Matthay, MDe and Mary Lou Schmidt, MDf

a Child Health Evaluation and Research Unit, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
b Division of Hematology/Oncology, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania
c Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee
d Division of Population Sciences, City of Hope National Medical Center, Duarte, California
e Pediatric Hematology-Oncology, Department of Pediatrics, University of California, San Francisco, California
f Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Illinois, Chicago, Illinois

OBJECTIVES. Among a cohort of long-term neuroblastoma survivors, our aims were to (1) assess the association between treatment intensity and parent-reported hearing loss in the child, (2) evaluate the strength of the association between hearing loss and parent-reported academic and psychosocial difficulties in the child, and (3) examine the association between parent-reported academic and psychosocial difficulties in the child and the child's self-reported quality of life.

PATIENTS AND METHODS. Through a mailed survey that included the Pediatric Quality of Life Inventory 4.0 and an outcomes questionnaire for parents, we evaluated 137 children (aged 8–17 years) who were previously enrolled in 1 of 2 Children's Cancer Group neuroblastoma clinical studies.

RESULTS. Childhood survivors of neuroblastoma who had prevalent hearing loss, as reported by their parents, had at least twice the risk of an identified problem with reading skills, math skills, and/or attention and a similarly higher risk of a general learning disability and/or special educational needs than did neuroblastoma survivors without hearing loss. Consistent with this finding, hearing loss was associated with a 10-point-lower mean score in the school-functioning scale of the Pediatric Quality of Life Inventory 4.0. We also observed a clear pattern of poorer self-reported quality-of-life scores among children with parent-reported academic and psychosocial problems compared with those without such problems, particularly with school functioning, even after controlling for reported hearing loss.

CONCLUSIONS. We found evidence that long-term neuroblastoma survivors, especially those with hearing loss, are at elevated risk for academic learning problems and psychosocial difficulties. We also found strong concordance between parent-reported learning problems in the child and indications of distress in the child's self-reported quality of life.

Key Words: cancer • chemotherapy • cisplatin • education • psychosocial problems • treatment late effects • ototoxicity

Abbreviations: MYCN—myc myelocytomatosis viral–related oncogene, neuroblastoma derived • QoL—quality of life • COG—Children's Oncology Group • IRB—institutional review board • PedsQL—Pediatric Quality of Life Inventory 4.0 • CI—confidence interval • OR—odds ratio • RR—relative risk

Accepted Apr 11, 2007.