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Neuropsychological outcome in children with optic pathway tumours when first-line treatment is chemotherapy.

Lacaze E, Kieffer V, Streri A, Lorenzi C, Gentaz E, Habrand JL, Dellatolas G, Kalifa C, Grill J - Br. J. Cancer (2003)

Bottom Line: Eight had neurofibromatosis type 1 (NF1).Children with Nf1 showed subnormal IQ scores with marked impairment of short- and long-term memory.With respect to long-term neuropsychological outcome, our study shows that a chemotherapy-first strategy can preserve the intellectual outcome of these patients either by avoiding the need of radiotherapy or by delaying its use as much as possible.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric and Adolescent Oncology, Gustave Roussy Institute, 39, rue Camille Desmoulins 94805, Villejuif, France.

ABSTRACT
Standard treatment of optic pathways gliomas consists of radiotherapy and surgery when feasible. Owing to the toxicity of irradiation, chemotherapy has emerged as an interesting therapeutic option, especially in young children. This study describes the neuropsychological profile of 27 children (aged between 1.5 and 15.7 years) with optic pathways gliomas treated with chemotherapy as first-line treatment. Eight of them also received radiotherapy as salvage treatment. Eight had neurofibromatosis type 1 (NF1). Intellectual outcome was preserved in children treated with chemotherapy only (mean=107+/-17) compared to children also receiving radiotherapy (mean IQ=88+/-24) or children having NF1 and treated with chemotherapy (mean IQ=80+/-13). Scores for abstract reasoning, mental arithmetic, chessboard/coding, perception, judgement of line orientation were lower in children irradiated than in those treated only by chemotherapy. Children with Nf1 showed subnormal IQ scores with marked impairment of short- and long-term memory. With respect to long-term neuropsychological outcome, our study shows that a chemotherapy-first strategy can preserve the intellectual outcome of these patients either by avoiding the need of radiotherapy or by delaying its use as much as possible.

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Related in: MedlinePlus

IQ scores of the three groups: (A) full scale IQ; (B) verbal IQ; (C) performance IQ. Scores represent the median value of the distribution. Boxes represent 25–75% of the distribution. Bars represent the range, that is, minimal and maximal values. Group 1=patients without NF-1 treated with chemotherapy only, Group 2=patients without NF1 treated with chemotherapy followed by radiotherapy, Group 3=patients with NF1 treated with chemotherapy only.
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fig2: IQ scores of the three groups: (A) full scale IQ; (B) verbal IQ; (C) performance IQ. Scores represent the median value of the distribution. Boxes represent 25–75% of the distribution. Bars represent the range, that is, minimal and maximal values. Group 1=patients without NF-1 treated with chemotherapy only, Group 2=patients without NF1 treated with chemotherapy followed by radiotherapy, Group 3=patients with NF1 treated with chemotherapy only.

Mentions: Results of Wechsler scales in the three groups


Neuropsychological outcome in children with optic pathway tumours when first-line treatment is chemotherapy.

Lacaze E, Kieffer V, Streri A, Lorenzi C, Gentaz E, Habrand JL, Dellatolas G, Kalifa C, Grill J - Br. J. Cancer (2003)

IQ scores of the three groups: (A) full scale IQ; (B) verbal IQ; (C) performance IQ. Scores represent the median value of the distribution. Boxes represent 25–75% of the distribution. Bars represent the range, that is, minimal and maximal values. Group 1=patients without NF-1 treated with chemotherapy only, Group 2=patients without NF1 treated with chemotherapy followed by radiotherapy, Group 3=patients with NF1 treated with chemotherapy only.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2376861&req=5

fig2: IQ scores of the three groups: (A) full scale IQ; (B) verbal IQ; (C) performance IQ. Scores represent the median value of the distribution. Boxes represent 25–75% of the distribution. Bars represent the range, that is, minimal and maximal values. Group 1=patients without NF-1 treated with chemotherapy only, Group 2=patients without NF1 treated with chemotherapy followed by radiotherapy, Group 3=patients with NF1 treated with chemotherapy only.
Mentions: Results of Wechsler scales in the three groups

Bottom Line: Eight had neurofibromatosis type 1 (NF1).Children with Nf1 showed subnormal IQ scores with marked impairment of short- and long-term memory.With respect to long-term neuropsychological outcome, our study shows that a chemotherapy-first strategy can preserve the intellectual outcome of these patients either by avoiding the need of radiotherapy or by delaying its use as much as possible.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric and Adolescent Oncology, Gustave Roussy Institute, 39, rue Camille Desmoulins 94805, Villejuif, France.

ABSTRACT
Standard treatment of optic pathways gliomas consists of radiotherapy and surgery when feasible. Owing to the toxicity of irradiation, chemotherapy has emerged as an interesting therapeutic option, especially in young children. This study describes the neuropsychological profile of 27 children (aged between 1.5 and 15.7 years) with optic pathways gliomas treated with chemotherapy as first-line treatment. Eight of them also received radiotherapy as salvage treatment. Eight had neurofibromatosis type 1 (NF1). Intellectual outcome was preserved in children treated with chemotherapy only (mean=107+/-17) compared to children also receiving radiotherapy (mean IQ=88+/-24) or children having NF1 and treated with chemotherapy (mean IQ=80+/-13). Scores for abstract reasoning, mental arithmetic, chessboard/coding, perception, judgement of line orientation were lower in children irradiated than in those treated only by chemotherapy. Children with Nf1 showed subnormal IQ scores with marked impairment of short- and long-term memory. With respect to long-term neuropsychological outcome, our study shows that a chemotherapy-first strategy can preserve the intellectual outcome of these patients either by avoiding the need of radiotherapy or by delaying its use as much as possible.

Show MeSH
Related in: MedlinePlus