Impact of socioeconomic status and chemotherapy on neurocognitive performance in children with brain tumors.
chemotherapy
neurocognition
pediatric brain tumor
socioeconomic status
Journal
Neuro-oncology practice
ISSN: 2054-2577
Titre abrégé: Neurooncol Pract
Pays: England
ID NLM: 101640528
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
pmc-release:
14
08
2024
medline:
27
11
2023
pubmed:
27
11
2023
entrez:
27
11
2023
Statut:
epublish
Résumé
Although the relationship between radiation and neurocognition has been extensively studied in the pediatric brain tumor population, it is increasingly recognized that neurocognitive impairment is multifactorial. Therefore, we quantified the effect of socioeconomic status (SES) and chemotherapy on neurocognitive impairment and decline post-treatment. Eligible patients included those diagnosed with a brain tumor at < 22 years of age with ≥1 neurocognitive assessment. Neurocognitive impairment was defined as performance 1.5 standard deviations below the normative mean using age-standardized measures of intellectual function. Neurocognitive decline was defined as a negative slope. Neurocognitive outcomes included Wechsler indices of Full-Scale Intelligence Quotient (IQ). Logistic regression identified variables associated with neurocognitive impairment. Longitudinal data was analyzed using linear mixed models. Eligible patients ( Public insurance, an indicator of low SES, was associated with post-treatment impairment in IQ, highlighting the need to incorporate SES measures into prospective studies. Chemotherapy was associated with change in IQ. Further work is needed to determine whether impairment associated with low SES is secondary to baseline differences in IQ prior to brain tumor diagnosis, brain tumor/therapy itself, or some combination thereof.
Sections du résumé
Background
UNASSIGNED
Although the relationship between radiation and neurocognition has been extensively studied in the pediatric brain tumor population, it is increasingly recognized that neurocognitive impairment is multifactorial. Therefore, we quantified the effect of socioeconomic status (SES) and chemotherapy on neurocognitive impairment and decline post-treatment.
Methods
UNASSIGNED
Eligible patients included those diagnosed with a brain tumor at < 22 years of age with ≥1 neurocognitive assessment. Neurocognitive impairment was defined as performance 1.5 standard deviations below the normative mean using age-standardized measures of intellectual function. Neurocognitive decline was defined as a negative slope. Neurocognitive outcomes included Wechsler indices of Full-Scale Intelligence Quotient (IQ). Logistic regression identified variables associated with neurocognitive impairment. Longitudinal data was analyzed using linear mixed models.
Results
UNASSIGNED
Eligible patients (
Conclusions
UNASSIGNED
Public insurance, an indicator of low SES, was associated with post-treatment impairment in IQ, highlighting the need to incorporate SES measures into prospective studies. Chemotherapy was associated with change in IQ. Further work is needed to determine whether impairment associated with low SES is secondary to baseline differences in IQ prior to brain tumor diagnosis, brain tumor/therapy itself, or some combination thereof.
Identifiants
pubmed: 38009122
doi: 10.1093/nop/npad049
pii: npad049
pmc: PMC10666804
doi:
Types de publication
Journal Article
Langues
eng
Pagination
576-585Subventions
Organisme : NICHD NIH HHS
ID : P50 HD103538
Pays : United States
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Déclaration de conflit d'intérêts
None.
Références
J Clin Oncol. 2021 Jul 20;39(21):2350-2358
pubmed: 33945291
Neuro Oncol. 2019 Sep 6;21(9):1175-1183
pubmed: 30977510
J Clin Oncol. 2021 Dec 1;39(34):3813-3821
pubmed: 34570616
J Clin Oncol. 2019 Jun 20;37(18):1566-1575
pubmed: 31046551
Neuro Oncol. 2017 Nov 29;19(12):1673-1682
pubmed: 29016818
Cancers (Basel). 2021 Jul 15;13(14):
pubmed: 34298751
Neuro Oncol. 2011 May;13(5):517-24
pubmed: 21372071
J Clin Oncol. 2001 Apr 15;19(8):2302-8
pubmed: 11304784
Blood. 2015 Jul 16;126(3):346-53
pubmed: 26048910
Cancer Epidemiol. 2021 Jun;72:101942
pubmed: 33946020
Neuro Oncol. 2021 Jul 1;23(7):1173-1182
pubmed: 33543269
J Clin Oncol. 2021 Jun 1;39(16):1705-1717
pubmed: 33886368
Am Soc Clin Oncol Educ Book. 2018 May 23;38:850-860
pubmed: 30231364
J Clin Oncol. 2020 Feb 10;38(5):454-461
pubmed: 31774710
J Clin Oncol. 2022 Jan 1;40(1):83-95
pubmed: 34714708
Am J Public Health. 2003 Jul;93(7):1137-43
pubmed: 12835199
Cogn Dev. 2021 Apr-Jun;58:
pubmed: 33986564