Illuminating the hidden cost: A systematic review of cognitive late effects regarding cancer-related fatigue in treated paediatric brain tumors

揭示隐性成本:对接受治疗的儿童脑肿瘤患者癌症相关疲劳的认知远期效应进行系统性综述

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Abstract

OBJECTIVE: Globally, in 2022, 30,871 children were diagnosed with CNS-tumors. Many have been treated with radiotherapy, and a significant number suffer from chronic late effects, including fatigue. This study aims to investigate previous research on the impact of cancer-related fatigue for neurocognitive function that can be related to radiotherapy in patients who have undergone primary brain radiotherapy before the age of 18. METHODS: Conducted under PRISMA-S framework, this systematic review searched MEDLINE ALL (Ovid), EMBASE (Ovid), CINAHL (EBSCO), and PsycINFO (Ovid) for relevant studies. Criteria for inclusion were children under 18 who underwent radiotherapy for primary brain cancer, focusing on late cognitive side effects, published 2000-2023. RESULTS: From 4,067 records, 10 studies were included, examining Proton Radiation Therapy (n = 4), X-ray Radiation Therapy (n = 3), and their comparisons (n = 3). The studies used various cognitive tests, and late effects that emerged were neurocognitive functions and disorders, intellectual functioning, specific cognitive functions and daily life, social functioning, and performance. These themes can be encompassed by cancer-related fatigue. CONCLUSIONS: The findings underscore critical need for more in-depth research to understand the health perception variations among children post-primary brain radiotherapy. Furthermore, detailed insights of treatment specifics, disease progression, target volume sizes, and doses to surrounding organs at risk are imperative.

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