A systematic review of the effectiveness of interventions (pharmaceutical and psychosocial) for cognitive and learning impairments in children diagnosed with a brain tumour

Tumours of the brain and the central nervous system (CNS) account for a quarter of all childhood cancers. Despite being a rare condition, it is the most frequent cause of death from disease in children aged 1-14 years, and accounts for just under a fifth of all bereavements in childhood. Recent medical advancements together with improvements in neurosurgery, radiation therapy and chemotherapy have facilitated earlier diagnosis. This has resulted in an increase in the aggregated survival rates of children diagnosed with brain tumours. As a result, children are living longer with greater neurocognitive morbidity. Statistics indicate that 40-100% of long-term survivors of a brain tumour will demonstrate some degree of cognitive dysfunction. Hence, the National Health Service (NHS) and other international health care providers are increasingly focusing on the rehabilitation needs and quality of survivorship of this population.

The objectives of this thesis are to identify and evaluate the effectiveness of interventions (pharmaceutical and psychosocial) for cognitive and learning impairment within a paediatric neurooncology population. This will be addressed via a systematic review of all current research using a selection of Electronic Databases. The result of which will hope to provide a guide for appropriate service provision to address long-term neuro-rehabilitation and psychological needs in the future.

A limited number of studies were retrieved in this systematic review; only three studies met the inclusion criteria. Thus, a narrative review resulted in limited conclusion about the effectiveness of psychosocial and pharmaceutical interventions on neurocognitive and learning impairments in a paediatric brain tumour population. Of the studies retrieved, all demonstrated promising results for the future of paediatric rehabilitation. However, it is the limited number of studies retrieved that is of most interest, highlighting a very small evidence base and potentially problematic research design. Solutions to these difficulties are suggested.