Temporal Changes of Psychosocial Status in Neuroblastoma Survivors Over Time

Hyunjung Seo; Yun Hye Oh; Kiho Kim; Hee Joon Yoon; Jae Young Oh; Suzie Lee; Yoo Sook Joung

doi:10.4306/jknpa.2016.55.4.472

Journal List > J Korean Neuropsychiatr Assoc > v.55(4) > 1017832

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Seo, Oh, Kim, Yoon, Oh, Lee, and Joung: Temporal Changes of Psychosocial Status in Neuroblastoma Survivors Over Time

Original Article

Journal of Korean Neuropsychiatric Association 2016; 55(4): 472-479.

Published online: 30 November 2016

DOI: https://doi.org/10.4306/jknpa.2016.55.4.472

Temporal Changes of Psychosocial Status in Neuroblastoma Survivors Over Time

Hyunjung Seo, MD¹, Yun Hye Oh, MD¹, Kiho Kim, MA², Hee Joon Yoon, MD¹, Jae Young Oh, MD¹, Suzie Lee, MD³, Yoo Sook Joung, MD, PhD¹

¹Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

²Samsung Biomedical Research Institute, Seoul, Korea.

³Haesol Psychiatric Clinic, Seoul, Korea.

Address for correspondence: Yoo Sook Joung, MD, PhD. Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. Tel +82-2-3410-0930, Fax +82-2-3410-0050, yschoung@skku.edu

Received 19 July 2016 Revised 7 October 2016 Accepted 15 October 2016

Abstract

Objectives

The survival rate of all childhood cancers has been increasing, and latent effects on childhood cancer survivors have been gaining researchers' attention. It has been shown that childhood cancer survivors experience social maladaptation and a decreased quality of life. Although neuroblastoma is one of the most common solid cancers in childhood, there are few reports on psychosocial status in neuroblastoma survivors. The purpose of this study was to investigate temporal changes in psychosocial status in neuroblastoma survivors.

Methods

This study was conducted by undertaking retrospective chart reviews of neuroblastoma survivors that were treated between January 1997 and February 2016 at Samsung Medical Center, Seoul, Korea. Among the 54 survivors identified, data for 28 patients who underwent psychological evaluation before and after treatment completion were selected for further analysis. We compared intelligence score, Korea-Child Behavior Checklist (K-CBCL), and Korean Personality Rating Scale for Children (K-PRC) scores before and after treatment completion. Time derivatives for each variable were calculated to identify temporal changes in scores.

Results

After treatment completion, K-CBCL scores for total competence (t=−2.34, p=0.044), somatic complaints (t=−2.43, p=0.022), and thought problems (t=−3.03, p=0.006) were higher than the scores prior to treatment. Familial relationship in K-PRC was significantly improved after treatment (t=2.11, p=0.045). Time derivatives of the significant K-CBCL subscales, except for the withdrawal and externalizing symptom scores, showed a tendency to increase with time.

Conclusion

Although familial relationship and social competence improved after treatment, the levels of somatic complaints and thought problems increased following neuroblastoma treatment.

Keywords: Neuroblastoma, Childhood cancer, Korean Child Behavior Checklist, Korean Personality Rating Scale for Children, Psychosocial status

Figures and Tables

Fig. 1

Schema of the concept of the study.

Fig. 2

Flow chart for the selection of cases in analysis.

Table 1

Demographic and clinical characteristics between patients included in the final analysis and patients excluded

^* : Fisher's exact test, ^† : Mann-Whitney test. CTx : Chemotherapy, OP : Operation, RTx : Radiotherapy

Table 2

Paired t-test of the variables before- (T1) and after treatment completion (T2)

^* : p<0.05, ^† : This subscale is indicated for children who are older than 6 years, ^‡ : This subscale is indicated for school-aged children, ^§ : Two subjects who didn't be evaluated this scale were excluded for analysis. FSIQ : Full-Scale Intelligence Quotients, VIQ : Verbal Intelligence Quotients, PIQ : Performance Intelligence Quotients, SQ : Social Quotients, K-CBCL : Korean Child Behavior Checklist, K-PRC : Korean Personality Rating Scale for Children

Table 3

Mean and confidence interval of delta variables per year

^* : p<0.05, one sample t-test. ^† : This subscale is indicated for children who are older than 6 years, ^‡ : This subscale is indicated for school-aged children, ^§ : Two subjects who didn't be evaluated this scale were excluded for analysis. K-CBCL : Korean Child Behavior Checklist, K-PRC : Korean Personality Rating Scale for Children, T1 : Assessment Before Treatment Completion, T2 : Assessment after treatment completion, Delta : Time derivative of variables

Notes

^{Conflicts of Interest} The authors have no financial conflicts of interest.

References

1. Shusterman S, George RE. Neuroblastoma. In : Orkin SH, Nathan DG, Ginsburg D, Look AT, Fisher DE, Lux SE, editors. Nathan and Oski's Hematology and Oncology of Infancy and Childhood. 8th ed. Philadelphia: Saunders Elsevier;2014. p. 1675–1713.

2. Cha ES, Kong KA, Moon EK, Khang YH, Lee WJ. Childhood cancer mortality and birth characteristics in Korea: a national population-based birth cohort study. J Korean Med Sci. 2011; 26:339–345.

3. Smith MA, Seibel NL, Altekruse SF, Ries LA, Melbert DL, O'Leary M, et al. Outcomes for children and adolescents with cancer: challenges for the twenty-first century. J Clin Oncol. 2010; 28:2625–2634.

4. Haupt R, Fears TR, Robison LL, Mills JL, Nicholson HS, Zeltzer LK, et al. Educational attainment in long-term survivors of childhood acute lymphoblastic leukemia. JAMA. 1994; 272:1427–1432.

5. Boulad F, Sands S, Sklar C. Late complications after bone marrow transplantation in children and adolescents. Curr Probl Pediatr. 1998; 28:273–297.

6. Schwartz CL. Long-term survivors of childhood cancer: the late effects of therapy. Oncologist. 1999; 4:45–54.

7. Fidler MM, Frobisher C, Guha J, Wong K, Kelly J, Winter DL, et al. Long-term adverse outcomes in survivors of childhood bone sarcoma: the British Childhood Cancer Survivor Study. Br J Cancer. 2015; 112:1857–1865.

8. Fuemmeler BF, Elkin TD, Mullins LL. Survivors of childhood brain tumors: behavioral, emotional, and social adjustment. Clin Psychol Rev. 2002; 22:547–585.

9. Font-Gonzalez A, Feijen EL, Sieswerda E, van Dulmen-den Broeder E, Grootenhuis M, Maurice-Stam H, et al. Social outcomes in adult survivors of childhood cancer compared to the general population: linkage of a cohort with population registers. Psychooncology. 2016; 25:933–941.

10. Schwartz CE, Feinberg RG, Jilinskaia E, Applegate JC. An evaluation of a psychosocial intervention for survivors of childhood cancer: paradoxical effects of response shift over time. Psychooncology. 1999; 8:344–354.

11. Hudson MM, Mertens AC, Yasui Y, Hobbie W, Chen H, Gurney JG, et al. Health status of adult long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. JAMA. 2003; 290:1583–1592.

12. Surbone A, Annunziata MA, Santoro A, Tirelli U, Tralongo P. Cancer patients and survivors: changing words or changing culture? Ann Oncol. 2013; 24:2468–2471.

13. Marzorati C, Riva S, Pravettoni G. Who is a cancer survivor? A systematic review of published definitions. J Cancer Educ. 2016; 02. 08. [Epub]. DOI: 10.1007/s13187-016-0997-2.

14. Park H, Gwak G, Park G. K-WPPSI Manual. Special Education. Seoul: 1995.

15. Kwak K, Park H, Kim C. K-WISC-III (Korean Wechsler Intelligence Scale for Children-III). Special Education. Seoul: 2001.

16. Gwak G, Oh S, Kim C. K-WISC-IV (Korean Wechsler Intelligence Scale for Children-IV). Manual for experts. Seoul: Hakjisa;2011.

17. Yeom T, Park Y, Oh K, Kim J, Lee Y. K-WAIS Guideline. Seoul: Korea Guidance;1992.

18. Edgar AD. Vineland Social Maturity Scale: condensed manual of directions. Minnesota: American Guidance Service;1965.

19. Kim S, Kim O. Social maturity scale. Seoul: Joongang Aptitude;1985.

20. Ha EH, O GG, Lee HR, Hong GU. Reconstruction of the behavior problem scales of the Korean CBCL. Seoul J Psychiatry. 1995; 20:245–253.

21. Cho SM, Park HY, Kim JH, Hong CH, Hwang ST. A standardization study of The Korean Personality Rating Scale for Children (KPRC). Korean J Clin Psychol. 2006; 25:825–848.

22. Zeltzer LK, Recklitis C, Buchbinder D, Zebrack B, Casillas J, Tsao JC, et al. Psychological status in childhood cancer survivors: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2009; 27:2396–2404.

23. Nathan PC, Ness KK, Greenberg ML, Hudson M, Wolden S, Davidoff A, et al. Health-related quality of life in adult survivors of childhood Wilms tumor or neuroblastoma: a report from the childhood cancer survivor study. Pediatr Blood Cancer. 2007; 49:704–715.

24. Carpentieri SC, Diller LR. Neuropsychological resiliency after treatment for advanced stage neuroblastoma. Bone Marrow Transplant. 2005; 35:1117–1122.

25. Notteghem P, Soler C, Dellatolas G, Kieffer-Renaux V, Valteau-Couanet D, Raimondo G, et al. Neuropsychological outcome in long-term survivors of a childhood extracranial solid tumor who have undergone autologous bone marrow transplantation. Bone Marrow Transplant. 2003; 31:599–606.

26. Woodgate RL, Tailor K, Yanofsky R, Vanan MI. Childhood brain cancer and its psychosocial impact on survivors and their parents: a qualitative thematic synthesis. Eur J Oncol Nurs. 2016; 20:140–149.

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