Zucchinelli V, Bouffet E
Ecole des Enfants malades (hôpitaux de Lyon), Caluire, France.
Arch Pediatr. 2000 Sep;7(9):933-41. doi: 10.1016/s0929-693x(00)90006-x.
Brain tumours constitute the most common type of solid malignancy in childhood. Despite intensive efforts developed since the mid-1970s in paediatric neuro-oncology, survivors still have a wide range of sequelae leading to frequent failure in academic achievements. Very few studies have detailed the educational outcome of these children.
The study was based on a questionnaire sent to the parents of children diagnosed with a brain tumour and treated at the Centre Léon-Bérard between 1987 and 1993. Children had to be under 12 years old at the time of diagnosis and with at least three years of follow-up since diagnosis. Questions focused on the child's education before diagnosis, his progress during and after treatment, the measures taken when the child experienced learning difficulties and their consequences on the child's socioprofessional integration.
Twenty-seven responses were obtained out of 34 questionnaires. Twenty-six children were reported to experience learning difficulties. Only four children had a normal education. The main problems are associated with slowness, memory and comprehension difficulties. The main disciplines affected are mathematics, reading and spelling. Fifteen children did benefit from extra support, with large interindividual variations in the amount and the quality of this support. Half of the parents play an active role in their child's extra support.
This study provides additional information to previous reports on progressive I.Q. decline following the treatment of a brain tumour in childhood. Learning difficulties are nearly constant and adversely influence the child's curriculum. They also affect the parents who experience questions about the future of their ideal child. The severity and complexity of these learning difficulties urge for an early multidisciplinary educational and psychological management. The main characteristics of these remedial efforts should be assessed in prospective studies.
脑肿瘤是儿童期最常见的实体恶性肿瘤类型。尽管自20世纪70年代中期以来儿科神经肿瘤学领域付出了巨大努力，但幸存者仍有广泛的后遗症，导致学业成绩频繁不佳。很少有研究详细阐述这些儿童的教育成果。
本研究基于向1987年至1993年期间在里昂贝拉尔中心被诊断患有脑肿瘤并接受治疗的儿童的父母发送的问卷。儿童在诊断时必须未满12岁且自诊断后至少有三年的随访。问题集中在儿童诊断前的教育情况、治疗期间及之后的进展、儿童出现学习困难时所采取的措施及其对儿童社会职业融入的影响。
34份问卷共获得27份回复。据报告，26名儿童存在学习困难。只有4名儿童接受正常教育。主要问题与学习速度慢、记忆力和理解能力困难有关。受影响的主要学科是数学、阅读和拼写。15名儿童确实受益于额外支持，这种支持在数量和质量上存在很大的个体差异。一半的家长在孩子的额外支持中发挥积极作用。
本研究为先前关于儿童脑肿瘤治疗后智商逐渐下降的报告提供了更多信息。学习困难几乎是持续存在的，对儿童的课程产生不利影响。它们还影响到那些对自己理想孩子的未来感到担忧的家长。这些学习困难的严重性和复杂性迫切需要早期的多学科教育和心理管理。这些补救措施的主要特征应在前瞻性研究中进行评估。
