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Risk factors for domain-specific neurocognitive outcome in pediatric survivors of a brain tumor in the posterior fossa-Results of the HIT 2000 trial.
Mynarek, Martin; Rossius, Anne; Guiard, Anika; Ottensmeier, Holger; von Hoff, Katja; Obrecht-Sturm, Denise; Bußenius, Lisa; Friedrich, Carsten; von Bueren, Andre O; Gerber, Nicolas U; Traunwieser, Thomas; Kortmann, Rolf-Dieter; Warmuth-Metz, Monika; Bison, Brigitte; Thomale, Ulrich-W; Krauss, Juergen; Pietsch, Torsten; Clifford, Steven C; Pfister, Stefan M; Sturm, Dominik; Sahm, Felix; Tischler, Tanja; Rutkowski, Stefan.
Afiliación
  • Mynarek M; Department of Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
  • Rossius A; Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Guiard A; Department of Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
  • Ottensmeier H; Department of Pediatrics, University Hospital Rostock, Rostock, Germany.
  • von Hoff K; Department of Pediatric Hematology and Oncology, University Children's Hospital Wuerzburg, Wuerzburg, Germany.
  • Obrecht-Sturm D; Department of Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
  • Bußenius L; Department of Pediatric Hematology and Oncology, Charité-University Medicine, Berlin, Germany.
  • Friedrich C; Department of Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
  • von Bueren AO; Department of Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
  • Gerber NU; Department for General Pediatrics and Pediatric Hematology and Oncology, University Children's Hospital Oldenburg, Oldenburg, Germany.
  • Traunwieser T; Division of Pediatric Oncology and Hematology, Department of Pediatrics, Gynecology and Obstetrics, University Hospital of Geneva, Geneva, Switzerland.
  • Kortmann RD; Department of Pediatrics, Gynecology and Obstetrics, University of Geneva, Geneva, Switzerland.
  • Warmuth-Metz M; Department of Oncology, University Children's Hospital, Zurich, Switzerland.
  • Bison B; Department of Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
  • Thomale UW; Paediatrics and Adolescent Medicine, University of Augsburg, Augsburg, Germany.
  • Krauss J; Department of Radiation Oncology, University of Leipzig, Leipzig, Germany.
  • Pietsch T; Institute of Diagnostic and Interventional Neuroradiology, University Hospital Wuerzburg, Wuerzburg, Germany.
  • Clifford SC; Department of Neuroradiology, University Hospital Augsburg, Augsburg, Germany.
  • Pfister SM; Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
  • Sturm D; Department for Neurosurgery, University Hospital Wuerzburg, Wuerzburg, Germany.
  • Sahm F; Institute of Neuropathology, Brain Tumor Reference Center of the German Society for Neuropathology and Neuroanatomy (DGNN), University of Bonn, DZNE German Center for Neurodegenerative Diseases, Bonn, Germany.
  • Tischler T; Wolfson Childhood Cancer Research Centre, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, UK.
  • Rutkowski S; Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany.
Neuro Oncol ; 26(11): 2113-2124, 2024 Nov 04.
Article en En | MEDLINE | ID: mdl-38835160
ABSTRACT

BACKGROUND:

Neurocognition can be severely affected in pediatric brain tumor survivors. We analyzed the association of cognitive functioning with radiotherapy dose, postoperative cerebellar mutism syndrome (pCMS), hydrocephalus, intraventricular methotrexate (MTX) application, tumor localization, and biology in pediatric survivors of a posterior fossa tumor.

METHODS:

Subdomain-specific neurocognitive outcome data from 279 relapse-free survivors of the HIT-2000 trial (241 medulloblastoma and 38 infratentorial ependymoma) using the Neuropsychological Basic Diagnostic tool based on Cattell-Horn-Carroll's model for intelligence were analyzed.

RESULTS:

Cognitive performance 5.14 years (mean; range = 1.52-13.02) after diagnosis was significantly below normal for all subtests. Processing speed and psychomotor abilities were most affected. Influencing factors were domain-specific CSI-dose had a strong impact on most subtests. pCMS was associated with psychomotor abilities (ß = -0.25 to -0.16) and processing speed (ß = -0.32). Postoperative hydrocephalus correlated with crystallized intelligence (ß = -0.20) and short-term memory (ß = -0.15), age with crystallized intelligence (ß = 0.15) and psychomotor abilities (ß = -0.16 and ß = -0.17). Scores for fluid intelligence (ß = -0.23), short-term memory (ß = -0.17) and visual processing (ß = -0.25) declined, and scores for selective attention improved (ß = 0.29) with time after diagnosis.

CONCLUSIONS:

The dose of CSI was strongly associated with neurocognitive outcomes. Low psychomotor abilities and processing speed both in patients treated with and without CSI suggest a strong contribution of the tumor and its surgery on these functions. Future research therefore should analyze strategies to both reduce CSI dose and toxicity caused by other treatment modalities.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Infratentoriales / Meduloblastoma Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Neuro Oncol Asunto de la revista: NEOPLASIAS / NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Infratentoriales / Meduloblastoma Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Neuro Oncol Asunto de la revista: NEOPLASIAS / NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido