Systematic review and meta-analysis of health-related quality of life in pediatric CNS tumor survivors

Fiona Schulte, K. Brooke Russell, Patricia Cullen, Leanne Embry, Taryn Fay-Mcclymont, Donna Johnston, Abby R. Rosenberg, Lillian Sung

Research output: Contribution to journalArticle

7 Scopus citations


Background: Pediatric central nervous system (CNS) tumor survivors are at high risk for numerous late effects including decreased health-related quality of life (HRQOL). Our objective was to summarize studies describing HRQOL in pediatric CNS tumor survivors and compare HRQOL outcomes in studies that included a comparison group. Procedure: EMBASE, MEDLINE, and PsychINFO were used to identify relevant articles published until August, 2016. Eligible studies reported outcomes for pediatric CNS tumor survivors diagnosed before age 21, at least 5 years from diagnosis and/or 2 years off therapy and used a standardized measure of HRQOL. All data were abstracted by two reviewers. Random-effects meta-analyses were performed using Review Manager 5.0. Results: Of 1,912 unique articles identified, 74 were included in this review. Papers described 29 different HRQOL tools. Meta-analyses compared pediatric CNS tumor survivors to healthy comparisons and other pediatric cancer survivors separately. HRQOL was significantly lower for CNS (n = 797) than healthy comparisons (n = 1,397) (mean difference = -0.54, 95% confidence interval [CI] = -0.72 to -0.35, P < 0.001, I2 = 35%). HRQOL was also significantly lower for CNS (n = 244) than non-CNS survivors (n = 414) (mean difference = -0.56, 95% CI = -0.73 to -0.38, P < 0.00001, I2 = 0%). Conclusions: Pediatric CNS tumor survivors experience worse HRQOL than healthy comparisons and non-CNS cancer survivors. Future HRQOL work should be longitudinal, and/or multisite studies that examine HRQOL by diagnosis and treatment modalities.

Original languageEnglish (US)
JournalPediatric Blood and Cancer
Publication statusAccepted/In press - 2017



  • CNS tumors
  • Late effects of cancer treatment
  • Pediatric oncology
  • Psychosocial
  • Quality of life

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Schulte, F., Russell, K. B., Cullen, P., Embry, L., Fay-Mcclymont, T., Johnston, D., ... Sung, L. (Accepted/In press). Systematic review and meta-analysis of health-related quality of life in pediatric CNS tumor survivors. Pediatric Blood and Cancer.