MB-74
LOWER SOCIAL ACCEPTANCE MAKES CURED PATIENTS MORE UNHAPPY THAN PHYSICAL CONSEQUENCES OF METASTATIC MEDULLOBLASTOMA Free

Since 1998 we launched an intensive post-surgical treatment for metastatic medulloblastoma: including ±High-Dose chemotherapy following HART at total neuraxis dose of 31.2/39 Gy with 60 Gy posterior fossa boost. Aim of this study is to evaluate the long-term adjustment of these patients minimum three years from treatment end. METHODS: Patients and parents completed standardized self-administered questionnaires on health-related quality of life (QOL). Questionnaires (PEDSQOL, SDQ, SF-36, EORTC QLQ-C30/QLQ-CN 20) were delivered to the patient's home, following a phone call and due consent. RESULTS: Data were provided by 26/29 eligible survivors (89,6%), median age 24 years (range 10-48), median interval after diagnosis 12,4 years (range 3,1-16,6). The analysis of the single subscales revealed that serious problems related to cognitive/emotional/relational functioning occurred in 44%-86%. An index of physical impairment (IPI) was calculated as the average value of the severity scores (from 1 to 3) assigned to physical sequelae experienced in these group of patients. Thirteen/25 patients obtained an IPI value higher than 1,5, i.e. significant enough to require clinical attention. However, the analysis of the questionnaires, divided in physical and psychosocial scales, revealed that, for those patients with critical IPI value, the median of pathological psychosocial scales was 3.5 versus 2.5 in the physical ones: physical sequelae had therefore a more negative impact on psychosocial than perceived physical QOL. CONCLUSION: Personal and social consequences have a strong impact on QOL. A global care of these patient implies specific actions to support the scholastic and relational continuity with a multi-disciplinary team.