A Systematic Review of Late Effects, Current Models of Follow-up in Three Pennsylvania Health Network Settings, and Survivor Care Plans for Brain Neoplasm Survivor

Introduction: Brain neoplasm survival rates have increased substantially in developed countries due to modern medical interventions, research, and enhanced therapeutic options. As the second leading cause of pediatric cancers, this has been a topic of interest within the field of public health. With mortality decreasing, scientists are now focusing the lens on the long-term outcomes of survivors, coined “survivorship” and subsequent late effects. These effects are the combined neurocognitive, psychological, and social deterioration and deficits experienced due to the brain pathology itself or exposure to associative treatments. This phenomenon is now appearing frequently in the literature. The aim of this review is to examine standards of care, planning for survivors, postdiagnostic interventions, and lapses in follow-up for brain tumor survivors. Models of care were observed in three major hospital systems and compared to the literature. Furthermore, a comprehensive examination of common late effects associated with the various treatment modalities, and the process for continued patient care has been provided for scope. Methods: Relevant literature was derived from publicly available databases for scholarly articles. Peer-reviewed studies were slated for consideration. Discussion: The extent of neurocognitive, psychological and social decline is individual and lapses in care come from lack of standardization in the follow-up process. Also, with current models of care, there is a substantial patient initiative is required, leaving patients and caretakers, already heavily burdened, to fend for themselves. This review contributes to the knowledge base afforded to survivors, thereby informing patients, caregivers, and practitioners, such that preemptive decisions can be made to bolster late effects and improve quality of life