Ingrid Tonning Olsson1, Sean Perrin2, Johan Lundgren3, Lars Hjorth3, Aki Johanson4. 1. Department of Psychology, Lund University, Lund, Sweden; Department of Pediatrics, Skåne University Hospital, Lund, Sweden. Electronic address: ingrid.tonning_olsson@med.lu.se. 2. Department of Psychology, Lund University, Lund, Sweden; Department of Psychology, Institute of Psychiatry, King's College London, London, United Kingdom. 3. Department of Pediatrics, Skåne University Hospital, Lund, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden. 4. Department of Psychology, Lund University, Lund, Sweden; Department of Psychiatry, Lund University, Lund, Sweden.
Abstract
BACKGROUND: Young age at diagnosis and treatment with cranial radiation therapy are well studied risk factors for cognitive impairment in pediatric brain tumor survivors. Other risk factors are hydrocephalus, surgery complications, and treatment with intrathecal chemotherapy. Female gender vulnerability to cognitive sequelae after cancer treatment has been evident in some studies, but no earlier studies have related this to tumor size. The purpose of our study was to find factors correlated with lowered IQ in a nationally representative sample of pediatric brain tumor patients referred for neuropsychologic evaluation. METHODS: Sixty-nine pediatric brain tumor patients, diagnosed 1988-2005 and tested 1995-2006, were included in the study. In a series of stepwise multiple regressions, the relationship of IQ to disease, treatment, and individual variables (sex and syndromes) were evaluated. A subanalysis was made of the covariation between sex and tumor size. RESULTS: The patients had generally suppressed IQ and impairments in executive function, memory, and attention. Lowered IQ was associated with young age at diagnosis, being male, tumor size, and treatment with whole-brain radiation therapy. A sex difference was evident for patients with increased intracranial pressure at diagnosis with males having larger tumors. Tumor size was found to be a better predictor of cognitive sequelae than sex. CONCLUSIONS: Whole-brain radiation therapy, large tumors, young age at diagnosis, and male gender are risk factors for late cognitive sequelae after pediatric brain tumors. When examining sex differences, tumor size at diagnosis needs to be taken into account.
BACKGROUND: Young age at diagnosis and treatment with cranial radiation therapy are well studied risk factors for cognitive impairment in pediatric brain tumor survivors. Other risk factors are hydrocephalus, surgery complications, and treatment with intrathecal chemotherapy. Female gender vulnerability to cognitive sequelae after cancer treatment has been evident in some studies, but no earlier studies have related this to tumor size. The purpose of our study was to find factors correlated with lowered IQ in a nationally representative sample of pediatric brain tumorpatients referred for neuropsychologic evaluation. METHODS: Sixty-nine pediatric brain tumorpatients, diagnosed 1988-2005 and tested 1995-2006, were included in the study. In a series of stepwise multiple regressions, the relationship of IQ to disease, treatment, and individual variables (sex and syndromes) were evaluated. A subanalysis was made of the covariation between sex and tumor size. RESULTS: The patients had generally suppressed IQ and impairments in executive function, memory, and attention. Lowered IQ was associated with young age at diagnosis, being male, tumor size, and treatment with whole-brain radiation therapy. A sex difference was evident for patients with increased intracranial pressure at diagnosis with males having larger tumors. Tumor size was found to be a better predictor of cognitive sequelae than sex. CONCLUSIONS: Whole-brain radiation therapy, large tumors, young age at diagnosis, and male gender are risk factors for late cognitive sequelae after pediatric brain tumors. When examining sex differences, tumor size at diagnosis needs to be taken into account.
Authors: Kevin R Krull; Kristina K Hardy; Lisa S Kahalley; Ilse Schuitema; Shelli R Kesler Journal: J Clin Oncol Date: 2018-06-06 Impact factor: 44.544
Authors: Allison A King; Kristy Seidel; Chongzhi Di; Wendy M Leisenring; Stephanie Mabry Perkins; Kevin R Krull; Charles A Sklar; Daniel M Green; Gregory T Armstrong; Lonnie K Zeltzer; Elizabeth Wells; Marilyn Stovall; Nicole J Ullrich; Kevin C Oeffinger; Leslie L Robison; Roger J Packer Journal: Neuro Oncol Date: 2017-05-01 Impact factor: 12.300
Authors: David T W Jones; Mark W Kieran; Eric Bouffet; Sanda Alexandrescu; Pratiti Bandopadhayay; Miriam Bornhorst; David Ellison; Jason Fangusaro; Michael J Fisher; Nicholas Foreman; Maryam Fouladi; Darren Hargrave; Cynthia Hawkins; Nada Jabado; Maura Massimino; Sabine Mueller; Giorgio Perilongo; Antoinette Y N Schouten van Meeteren; Uri Tabori; Katherine Warren; Angela J Waanders; David Walker; William Weiss; Olaf Witt; Karen Wright; Yuan Zhu; Daniel C Bowers; Stefan M Pfister; Roger J Packer Journal: Neuro Oncol Date: 2018-01-22 Impact factor: 12.300
Authors: Kristina K Hardy; Victoria W Willard; Anthony Gioia; Christina Sharkey; Karin S Walsh Journal: Neuro Oncol Date: 2018-04-09 Impact factor: 12.300