Comparison of neuropsychological functioning in pediatric posterior fossa tumor survivors: Medulloblastoma, low-grade astrocytoma, and healthy controls.
brain tumor
cerebellum
childhood cancer
cognition
late effects
processing speed
Journal
Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
revised:
04
11
2021
received:
09
07
2021
accepted:
08
11
2021
pubmed:
30
11
2021
medline:
28
4
2022
entrez:
29
11
2021
Statut:
ppublish
Résumé
Neuropsychological comparison of medulloblastoma (MB) and cerebellar low-grade astrocytoma (LGA) survivors to controls can clarify treatment-related neurocognitive late effects. While both brain tumor groups undergo surgery to the posterior fossa, children with MB additionally receive craniospinal irradiation with boost and chemotherapy. This study provides an updated comparison of neuropsychological functioning in these two groups and examines effects of demographic risk factors upon outcomes. Forty-two children (16 MB, nine LGA, and 17 controls) completed measures of intellectual functioning, verbal learning/memory, visual-motor integration, and fine-motor functioning. The effects of age at diagnosis, time since diagnosis, gender, fatigue, and social status on neuropsychological functioning were examined. MB survivors demonstrated the worst neurocognitive late effects, but they were less severe and extensive than in prior studies. LGA survivors' mean scores were below normative expectations in working memory, processing speed, and fine-motor functioning. In this overall sample, processing speed difficulties were independent of fine-motor functioning and fatigue. Higher parental education was associated with better intellectual functioning, working memory, delayed recall, and visual-motor integration. Neuropsychological function was not associated with gender, age at diagnosis, or time since diagnosis. The results support that contemporary treatment approaches with craniospinal irradiation plus boost and chemotherapy confer the greatest risk for late effects, while surgical resection is associated with subtle but important neurocognitive difficulties. Ultimately, this study furthers our understanding of factors impacting neuropsychological function in pediatric MB and LGA survivors and contributes to empirical support for close monitoring and targeted interventions into survivorship.
Sections du résumé
BACKGROUND
Neuropsychological comparison of medulloblastoma (MB) and cerebellar low-grade astrocytoma (LGA) survivors to controls can clarify treatment-related neurocognitive late effects. While both brain tumor groups undergo surgery to the posterior fossa, children with MB additionally receive craniospinal irradiation with boost and chemotherapy. This study provides an updated comparison of neuropsychological functioning in these two groups and examines effects of demographic risk factors upon outcomes.
PROCEDURE
Forty-two children (16 MB, nine LGA, and 17 controls) completed measures of intellectual functioning, verbal learning/memory, visual-motor integration, and fine-motor functioning. The effects of age at diagnosis, time since diagnosis, gender, fatigue, and social status on neuropsychological functioning were examined.
RESULTS
MB survivors demonstrated the worst neurocognitive late effects, but they were less severe and extensive than in prior studies. LGA survivors' mean scores were below normative expectations in working memory, processing speed, and fine-motor functioning. In this overall sample, processing speed difficulties were independent of fine-motor functioning and fatigue. Higher parental education was associated with better intellectual functioning, working memory, delayed recall, and visual-motor integration. Neuropsychological function was not associated with gender, age at diagnosis, or time since diagnosis.
CONCLUSION
The results support that contemporary treatment approaches with craniospinal irradiation plus boost and chemotherapy confer the greatest risk for late effects, while surgical resection is associated with subtle but important neurocognitive difficulties. Ultimately, this study furthers our understanding of factors impacting neuropsychological function in pediatric MB and LGA survivors and contributes to empirical support for close monitoring and targeted interventions into survivorship.
Identifiants
pubmed: 34842359
doi: 10.1002/pbc.29491
pmc: PMC10409501
mid: NIHMS1833305
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e29491Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
Dev Neurorehabil. 2018 Aug;21(6):415-422
pubmed: 28968151
Behav Brain Funct. 2006 Mar 15;2:9
pubmed: 16539720
Psychooncology. 2008 Nov;17(11):1157-61
pubmed: 18636431
J Int Neuropsychol Soc. 2013 Jan;19(1):44-53
pubmed: 23095276
J Clin Oncol. 2013 Oct 1;31(28):3494-500
pubmed: 23980078
Dev Neuropsychol. 2019 Jan-Feb;44(1):88-103
pubmed: 30395731
Neuro Oncol. 2021 Jul 1;23(7):1173-1182
pubmed: 33543269
Neurosurg Rev. 2021 Apr;44(2):699-708
pubmed: 32281017
Neuro Oncol. 2017 Nov 29;19(12):1673-1682
pubmed: 29016818
Psychol Bull. 2010 May;136(3):375-89
pubmed: 20438143
Qual Life Res. 2018 Feb;27(2):529-537
pubmed: 29090422
J Mol Psychiatry. 2015 May 15;3(1):5
pubmed: 26019867
J Clin Oncol. 2016 Apr 1;34(10):1043-9
pubmed: 26811522
Childs Nerv Syst. 1989 Apr;5(2):107-10
pubmed: 2736547
Int J Radiat Oncol Biol Phys. 2009 Jul 1;74(3):837-43
pubmed: 19117694
J Clin Oncol. 2001 Jan 15;19(2):472-9
pubmed: 11208841
Cancers (Basel). 2019 Nov 28;11(12):
pubmed: 31795208
CA Cancer J Clin. 2014 Mar-Apr;64(2):83-103
pubmed: 24488779
Trends Cogn Sci. 2009 Feb;13(2):65-73
pubmed: 19135405
J Int Neuropsychol Soc. 2009 Mar;15(2):205-16
pubmed: 19203432
Childs Nerv Syst. 2018 Dec;34(12):2415-2423
pubmed: 30276651
Neuro Oncol. 2019 Oct 9;21(10):1310-1318
pubmed: 31123753
Magn Reson Imaging. 2000 Sep;18(7):787-93
pubmed: 11027871
J Clin Oncol. 2005 Aug 1;23(22):5198-204
pubmed: 16051961
J Neurooncol. 2017 May;133(1):119-128
pubmed: 28405869
Ann Neurol. 1999 Dec;46(6):834-41
pubmed: 10589535
Pediatr Blood Cancer. 2020 Sep;67(9):e28538
pubmed: 32652734
Pediatr Neurosurg. 2005 Jan-Feb;41(1):15-21
pubmed: 15886508
Childs Nerv Syst. 2008 Sep;24(9):995-1002; discussion 1003
pubmed: 18581121
Neuropsychology. 2008 Mar;22(2):159-68
pubmed: 18331158
Pediatr Blood Cancer. 2021 May;68 Suppl 2:e28395
pubmed: 32386126
J Int Neuropsychol Soc. 2004 Mar;10(2):180-9
pubmed: 15012838
Lancet Oncol. 2004 Jul;5(7):399-408
pubmed: 15231246
Behav Brain Funct. 2008 Apr 15;4:18
pubmed: 18412947
J Natl Cancer Inst. 2017 Sep 1;109(9):
pubmed: 28376154
Pediatr Neurol. 2014 Oct;51(4):515-21
pubmed: 25266614
Cerebellum. 2020 Feb;19(1):102-125
pubmed: 31522332
Childs Nerv Syst. 2015 Oct;31(10):1869-75
pubmed: 26351236
Neuro Oncol. 2014 Aug;16(8):1129-36
pubmed: 24497405
J Clin Oncol. 2009 Jul 20;27(21):3526-32
pubmed: 19433687
Cancer. 2004 Nov 1;101(9):2116-25
pubmed: 15389475
J Neurooncol. 2005 May;72(3):245-53
pubmed: 15937648
Neuropsychology. 2003 Oct;17(4):548-55
pubmed: 14599268