Survivors of pediatric posterior fossa tumors: cognitive outcome, intervention, and risk-based care

Abstract

Adolescent and young adult survivors of posterior fossa tumors face a wide variety of functional challenges following treatment. The concept of survival needs to include plans to regularly monitor and effectively respond to those patients considered at risk for continued morbidities associated with cancer and its treatment. The nature of impairment experienced by survivors is discussed, including predominant patient- and treatment-related risk factors. A model to respond to the cognitive needs of survivors, including risk-based evaluation and intervention, is proposed. It is imperative for the success of the survivor that a team approach is taken to care. This approach must include improving the awareness and education of teachers and other education specialists who interact with this population of survivors. There is also an obligation to put forth effort in developing and validating efficacious intervention programs.

Figure 1

Multi-disciplinary approach to long-term risk-based care for survivors of pediatric posterior fossa tumors. Shaded boxes represent primary oncology team personnel. School – patient's home community education providers. Solid lines represent primary role during designated phase while dotted lines represent supportive role. Dashed line (clinical psychology) represents consistent role as primary psychological evaluator, with results communicated to the rest of the team on regular basis.