ID #907 Assessment of Quality of Life in Patients with Brain Tumor–Associated Hydrocephalus Using the Hydrocephalus Outcome Questionnaire (HoQ)

Abstract Background Hydrocephalus is a common complication in pediatric brain tumor patients and can substantially affect quality of life (QoL). The Hydrocephalus Outcome Questionnaire (HoQ) is a validated disease-specific instrument for multidimensional QoL assessment in hydrocephalus. This study evaluated the utility of the HoQ in children and adolescents with hydrocephalus associated with brain tumors. Methods Between 2022 and 2024, 55 patients (median age 12 years, range 8–18.1) with brain tumors and hydrocephalus treated at Bambino Gesù Children’s Hospital (Rome) were enrolled. QoL was assessed using the HoQ, administered to both patients and caregivers. HoQ scores were analyzed in relation to demographic and clinical variables. Recursive partitioning and non-parametric tests were used to explore predictors of QoL and compare treatment strategies. Agreement between patient- and caregiver-reported scores was assessed. Results were compared with those obtained using a generic QoL questionnaire (PedsQoL). Results The mean HoQ score was 0.80 ± 0.16. Age showed a significant inverted U-shaped association with QoL (p = 0.010), with higher scores in patients aged 10–15 years (mean 0.85) compared with younger children (mean 0.73) and adolescents (mean 0.65). A high hospitalization burden (10 admissions) was associated with poorer QoL (mean 0.64 vs. 0.82; p = 0.007), while a history of seizures showed a trend toward worse QoL (p = 0.055). No significant differences were observed according to hydrocephalus-related variables, including etiology whether tumoral or non-tumoral, type of cerebrospinal fluid diversion or need for shunt revisions. Good agreement was observed between patient- and caregiver-reported HoQ scores. Associations identified with the HoQ were not consistently confirmed when the PedsQoL was used. Conclusions QoL in patients with brain tumor–associated hydrocephalus is more strongly influenced by age and overall disease burden than by hydrocephalus-related factors, supporting the HoQ as a sensitive, disease-specific tool that captures clinically meaningful differences not consistently detected by generic QoL instruments.