Risk factors for domain-specific neurocognitive outcome in pediatric survivors of a brain tumor in the posterior fossa—Results of the HIT 2000 trial

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Titel: Risk factors for domain-specific neurocognitive outcome in pediatric survivors of a brain tumor in the posterior fossa—Results of the HIT 2000 trial
Autoren: Martin Mynarek, Anne Rossius, Anika Guiard, Holger Ottensmeier, Katja von Hoff, Denise Obrecht-Sturm, Lisa Bußenius, Carsten Friedrich, Andre O von Bueren, Nicolas U Gerber, Thomas Traunwieser, Rolf-Dieter Kortmann, Monika Warmuth-Metz, Brigitte Bison, Ulrich-W Thomale, Juergen Krauss, Torsten Pietsch, Steven C Clifford, Stefan M Pfister, Dominik Sturm, Felix Sahm, Tanja Tischler, Stefan Rutkowski
Quelle: Neuro-Oncology 26(11), 2113-2124 (2024). doi:10.1093/neuonc/noae092
Mynarek, M, Rossius, A, Guiard, A, Ottensmeier, H, von Hoff, K, Obrecht-Sturm, D, Bußenius, L, Friedrich, C, von Bueren, A O, Gerber, N U, Traunwieser, T, Kortmann, R-D, Warmuth-Metz, M, Bison, B, Thomale, U-W, Krauss, J, Pietsch, T, Clifford, S C, Pfister, S M, Sturm, D, Sahm, F, Tischler, T & Rutkowski, S 2024, ' Risk factors for domain-specific neurocognitive outcome in pediatric survivors of a brain tumor in the posterior fossa-Results of the HIT 2000 trial ', Neuro-Oncology . https://doi.org/10.1093/neuonc/noae092
Verlagsinformationen: Oxford University Press (OUP), 2024.
Publikationsjahr: 2024
Schlagwörter: Male, Mutism / etiology, quality of survival, ependymoma, Adolescent, Mutism, Cancer Survivors / psychology, etiology [Hydrocephalus], etiology [Mutism], Infratentorial Neoplasms, Neuropsychological Tests, Cognition Disorders / etiology, medulloblastoma, Cancer Survivors, Risk Factors, Infratentorial Neoplasms / therapy, Humans, ddc:610, Child, statistics & numerical data [Cancer Survivors], Ependymoma / therapy, 2. Zero hunger, neuropsychological late effects, Infant, etiology [Cognition Disorders], Neuropsychological late effects, Hydrocephalus / etiology, therapy [Medulloblastoma], Prognosis, Quality of survival, infant, 3. Good health, Ependymoma, Child, Preschool, therapy [Infratentorial Neoplasms], psychology [Cancer Survivors], Medulloblastoma / therapy, Female, Cancer Survivors / statistics & numerical data, Cognition Disorders, therapy [Ependymoma], Medulloblastoma, Follow-Up Studies, Hydrocephalus
Beschreibung: Background Neurocognition can be severely affected in pediatric brain tumor survivors. We analyzed the association of cognitive functioning with radiotherapy dose, postoperative cerebellar mutism syndrome (pCMS), hydrocephalus, intraventricular methotrexate (MTX) application, tumor localization, and biology in pediatric survivors of a posterior fossa tumor. Methods Subdomain-specific neurocognitive outcome data from 279 relapse-free survivors of the HIT-2000 trial (241 medulloblastoma and 38 infratentorial ependymoma) using the Neuropsychological Basic Diagnostic tool based on Cattell–Horn–Carroll’s model for intelligence were analyzed. Results Cognitive performance 5.14 years (mean; range = 1.52–13.02) after diagnosis was significantly below normal for all subtests. Processing speed and psychomotor abilities were most affected. Influencing factors were domain-specific: CSI-dose had a strong impact on most subtests. pCMS was associated with psychomotor abilities (β = –0.25 to –0.16) and processing speed (β = –0.32). Postoperative hydrocephalus correlated with crystallized intelligence (β = –0.20) and short-term memory (β = –0.15), age with crystallized intelligence (β = 0.15) and psychomotor abilities (β = –0.16 and β = –0.17). Scores for fluid intelligence (β = –0.23), short-term memory (β = –0.17) and visual processing (β = –0.25) declined, and scores for selective attention improved (β = 0.29) with time after diagnosis. Conclusions The dose of CSI was strongly associated with neurocognitive outcomes. Low psychomotor abilities and processing speed both in patients treated with and without CSI suggest a strong contribution of the tumor and its surgery on these functions. Future research therefore should analyze strategies to both reduce CSI dose and toxicity caused by other treatment modalities.
Publikationsart: Article
Dateibeschreibung: application/pdf
Sprache: English
ISSN: 1523-5866
1522-8517
DOI: 10.1093/neuonc/noae092
Zugangs-URL: https://pubmed.ncbi.nlm.nih.gov/38835160
Rights: OUP Standard Publication Reuse
Dokumentencode: edsair.doi.dedup.....0b4bee2c812a4cd55882afabfa7adb4c
Datenbank: OpenAIRE
Beschreibung
Abstract:Background Neurocognition can be severely affected in pediatric brain tumor survivors. We analyzed the association of cognitive functioning with radiotherapy dose, postoperative cerebellar mutism syndrome (pCMS), hydrocephalus, intraventricular methotrexate (MTX) application, tumor localization, and biology in pediatric survivors of a posterior fossa tumor. Methods Subdomain-specific neurocognitive outcome data from 279 relapse-free survivors of the HIT-2000 trial (241 medulloblastoma and 38 infratentorial ependymoma) using the Neuropsychological Basic Diagnostic tool based on Cattell–Horn–Carroll’s model for intelligence were analyzed. Results Cognitive performance 5.14 years (mean; range = 1.52–13.02) after diagnosis was significantly below normal for all subtests. Processing speed and psychomotor abilities were most affected. Influencing factors were domain-specific: CSI-dose had a strong impact on most subtests. pCMS was associated with psychomotor abilities (β = –0.25 to –0.16) and processing speed (β = –0.32). Postoperative hydrocephalus correlated with crystallized intelligence (β = –0.20) and short-term memory (β = –0.15), age with crystallized intelligence (β = 0.15) and psychomotor abilities (β = –0.16 and β = –0.17). Scores for fluid intelligence (β = –0.23), short-term memory (β = –0.17) and visual processing (β = –0.25) declined, and scores for selective attention improved (β = 0.29) with time after diagnosis. Conclusions The dose of CSI was strongly associated with neurocognitive outcomes. Low psychomotor abilities and processing speed both in patients treated with and without CSI suggest a strong contribution of the tumor and its surgery on these functions. Future research therefore should analyze strategies to both reduce CSI dose and toxicity caused by other treatment modalities.
ISSN:15235866
15228517
DOI:10.1093/neuonc/noae092