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Impairment of intellectual functions after surgery and posterior fossa irradiation in children with ependymoma is related to age and neurologic complications.

von Hoff K, Kieffer V, Habrand JL, Kalifa C, Dellatolas G, Grill J - BMC Cancer (2008)

Bottom Line: There was a significant association between the presence of cerebellar deficits and impaired IQ (72.0 vs 95.2, p < 0,001).The absence of hydrocephalus was an indicator of better neuropsychologic outcome (mean FSIQ of 102.6 vs 83.9, p = 0.025).Markedly reduced IQ scores were only seen with early disease manifestation and treatment, and postoperative neurological deficits had a strong impact on intellectual outcome.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of paediatric and adolescent oncology, Gustave Roussy institute, 39 rue Camille Desmoulins, 94805 Villejuif cedex, France. hoff_k@klinik.uni-wuerzburg.de

ABSTRACT

Background: To investigate the neuropsychological outcome of children treated with surgery and posterior fossa irradiation for localized infratentorial ependymoma.

Methods: 23 patients (age 0.3 - 14 years at diagnosis) who were treated with local posterior fossa irradiation (54 Gy) underwent one (4 patients) or sequential (19 patients) neuropsychologic evaluation. The last evaluation was performed at a median of 4.5 (1 to 15.5) years after RT.

Results: Mean last full scale IQ (FSIQ), verbal IQ (VIQ) and PIQ were 89.1, 94.0, and 86.2 respectively. All patients had difficulties with reading, and individual patients showed deficits in visuospatial, memory and attentional tasks. There was no trend for deterioration of intellectual outcome over time. All 5 children with IQ scores < or = 75 were under the age of four at diagnosis. There was a significant association between the presence of cerebellar deficits and impaired IQ (72.0 vs 95.2, p < 0,001). The absence of hydrocephalus was an indicator of better neuropsychologic outcome (mean FSIQ of 102.6 vs 83.9, p = 0.025).

Conclusion: Within the evaluated cohort, intellectual functions were moderately impaired. Markedly reduced IQ scores were only seen with early disease manifestation and treatment, and postoperative neurological deficits had a strong impact on intellectual outcome.

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Related in: MedlinePlus

Of ten patients with age < 5 years at diagnosis, eight were irradiated before the age of 5. Regression line is also indicated (r = 0.22; p = 0.3). Black circles = patients > 5 y at diagnosis. Red circles = patients < 5 y at diagnosis.
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Figure 2: Of ten patients with age < 5 years at diagnosis, eight were irradiated before the age of 5. Regression line is also indicated (r = 0.22; p = 0.3). Black circles = patients > 5 y at diagnosis. Red circles = patients < 5 y at diagnosis.

Mentions: Low IQ results occurred mainly in the young age group. Figure 2 shows the distribution of FSIQ values at last evaluation and age at irradiation. Comparing the IQ results of children younger than 5 years at irradiation with children who were older at the time of irradiation, the difference failed significance but there was a trend for poorer outcome in younger children. Mean FSIQ was 82.7 (n = 8, SD 17.2), and 92.5 (n = 15, SD 12.8) respectively (p = 0.1).


Impairment of intellectual functions after surgery and posterior fossa irradiation in children with ependymoma is related to age and neurologic complications.

von Hoff K, Kieffer V, Habrand JL, Kalifa C, Dellatolas G, Grill J - BMC Cancer (2008)

Of ten patients with age < 5 years at diagnosis, eight were irradiated before the age of 5. Regression line is also indicated (r = 0.22; p = 0.3). Black circles = patients > 5 y at diagnosis. Red circles = patients < 5 y at diagnosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2254428&req=5

Figure 2: Of ten patients with age < 5 years at diagnosis, eight were irradiated before the age of 5. Regression line is also indicated (r = 0.22; p = 0.3). Black circles = patients > 5 y at diagnosis. Red circles = patients < 5 y at diagnosis.
Mentions: Low IQ results occurred mainly in the young age group. Figure 2 shows the distribution of FSIQ values at last evaluation and age at irradiation. Comparing the IQ results of children younger than 5 years at irradiation with children who were older at the time of irradiation, the difference failed significance but there was a trend for poorer outcome in younger children. Mean FSIQ was 82.7 (n = 8, SD 17.2), and 92.5 (n = 15, SD 12.8) respectively (p = 0.1).

Bottom Line: There was a significant association between the presence of cerebellar deficits and impaired IQ (72.0 vs 95.2, p < 0,001).The absence of hydrocephalus was an indicator of better neuropsychologic outcome (mean FSIQ of 102.6 vs 83.9, p = 0.025).Markedly reduced IQ scores were only seen with early disease manifestation and treatment, and postoperative neurological deficits had a strong impact on intellectual outcome.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of paediatric and adolescent oncology, Gustave Roussy institute, 39 rue Camille Desmoulins, 94805 Villejuif cedex, France. hoff_k@klinik.uni-wuerzburg.de

ABSTRACT

Background: To investigate the neuropsychological outcome of children treated with surgery and posterior fossa irradiation for localized infratentorial ependymoma.

Methods: 23 patients (age 0.3 - 14 years at diagnosis) who were treated with local posterior fossa irradiation (54 Gy) underwent one (4 patients) or sequential (19 patients) neuropsychologic evaluation. The last evaluation was performed at a median of 4.5 (1 to 15.5) years after RT.

Results: Mean last full scale IQ (FSIQ), verbal IQ (VIQ) and PIQ were 89.1, 94.0, and 86.2 respectively. All patients had difficulties with reading, and individual patients showed deficits in visuospatial, memory and attentional tasks. There was no trend for deterioration of intellectual outcome over time. All 5 children with IQ scores < or = 75 were under the age of four at diagnosis. There was a significant association between the presence of cerebellar deficits and impaired IQ (72.0 vs 95.2, p < 0,001). The absence of hydrocephalus was an indicator of better neuropsychologic outcome (mean FSIQ of 102.6 vs 83.9, p = 0.025).

Conclusion: Within the evaluated cohort, intellectual functions were moderately impaired. Markedly reduced IQ scores were only seen with early disease manifestation and treatment, and postoperative neurological deficits had a strong impact on intellectual outcome.

Show MeSH
Related in: MedlinePlus