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Lacaze E, Kieffer V, Streri A, Lorenzi C, Gentaz E, Habrand JL, Dellatolas G, Kalifa C, Grill J. Neuropsychological outcome in children with optic pathway tumours when first-line treatment is chemotherapy. Br J Cancer 2004; 89:2038-44. [PMID: 14647135 PMCID: PMC2376861 DOI: 10.1038/sj.bjc.6601410] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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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Affiliation(s)
- E Lacaze
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Institute, 39, rue Camille Desmoulins 94805, Villejuif, France
- Laboratory of Cognition and Development, CNRS-UMR 8605, René Descartes University, Henri Piéron Centre, Paris, France
| | - V Kieffer
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Institute, 39, rue Camille Desmoulins 94805, Villejuif, France
- Centre Ressources, National Hospital of Saint-Maurice, Saint Maurice, France
| | - A Streri
- Laboratory of Cognition and Development, CNRS-UMR 8605, René Descartes University, Henri Piéron Centre, Paris, France
| | - C Lorenzi
- Laboratory of Experimental Psychology, CNRS-UMR 8581, René Descartes University, Henri Piéron Centre, Paris, Franace
| | - E Gentaz
- Laboratory of Cognition and Development, CNRS-UMR 8605, René Descartes University, Henri Piéron Centre, Paris, France
| | - J-L Habrand
- Department of Radiotherapy, Gustave Roussy Institute, Villejuif, France
| | - G Dellatolas
- Laboratory of Epidemiology and Biostatistics, INSERM Unit U472, Villejuif, France
| | - C Kalifa
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Institute, 39, rue Camille Desmoulins 94805, Villejuif, France
| | - J Grill
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Institute, 39, rue Camille Desmoulins 94805, Villejuif, France
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Institute, 39, rue Camille Desmoulins 94805, Villejuif, France. E-mail:
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García-Pérez A, Sierrasesumaga L, Narbona-García J, Calvo-Manuel F, Aguirre-Ventalló M. Neuropsychological evaluation of children with intracranial tumors: impact of treatment modalities. MEDICAL AND PEDIATRIC ONCOLOGY 1994; 23:116-23. [PMID: 8202033 DOI: 10.1002/mpo.2950230209] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Antineoplastic treatment has a deleterious effect on intellectual functions, which is mainly attributable to radiotherapy. With the object of determining the neuropsychological disturbances associated with brain irradiation in the child, and to try to differentiate them from the effects caused by the other types of treatment (surgical and chemotherapy) as well as from the effects of the tumor itself, a cross-sectional study was carried out in 25 survivors of medial edge intracranial tumors. In order to monitor the effect of systemic chemotherapy on the cognitive functions, and the effect of prolonged absence from school, two control groups were formed, one made up of subjects treated with chemotherapy for extracranial tumors, and the other of patients with non-malignant chronic disease. Neuropsychological functions were measured using the Spanish version of the Wechsler scale, as well as the following tests: Spreen-Benton, ITPA and TALE scales, Yuste Memory Test, Thurstone Attention Test, and the Rey Complex Figure. In addition to a progressive decline found in the full scale intelligence quotient in children irradiated for intracranial tumors, variance analysis showed that these patients deteriorate mainly in visual attention and memory, but also significantly in verbal fluency and in the Performance Intelligence Quotient and all its subtests, when compared to the control groups. Visual attention and the Wechsler Picture Arrangement and Block Designs, were the tests whose decline correlated with the total radiation administered. The article relates this specific neuropsychological injury with the total brain irradiation dose but also with the structures located in the cone-down fields of irradiation to boost regions in the middle edge intracranial content.
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Affiliation(s)
- A García-Pérez
- Child Neurology Service, Clinica Universitaria de Navarra, Pamplona, Spain
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