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

TY - JOUR

T1 - Impairment of intellectual functions after surgery and posterior fossa irradiation in children with ependymoma is related to age and neurologic complications

AU - von Hoff, Katja

AU - Kieffer, Virginie

AU - Habrand, Jean-Louis

AU - Kalifa, Chantal

AU - Dellatolas, Georges

AU - Grill, Jacques

PY - 2008/1/1

Y1 - 2008/1/1

N2 - 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.

AB - 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.

KW - Adolescent

KW - Age Factors

KW - Antineoplastic Combined Chemotherapy Protocols

KW - Child

KW - Child, Preschool

KW - Endocrine System Diseases

KW - Ependymoma

KW - Female

KW - Humans

KW - Infant

KW - Infratentorial Neoplasms

KW - Intelligence

KW - Intelligence Tests

KW - Male

KW - Paraneoplastic Cerebellar Degeneration

KW - Risk Factors

U2 - 10.1186/1471-2407-8-15

DO - 10.1186/1471-2407-8-15

M3 - SCORING: Journal article

C2 - 18208613

VL - 8

SP - 15

JO - BMC CANCER

JF - BMC CANCER

SN - 1471-2407

ER -