Maddrey Ann M, Bergeron Jon A, Lombardo Elizabeth R, McDonald Noelle K, Mulne Arlynn F, Barenberg Paul D, Bowers Daniel C
Division of Consult Liaison & Behavioral Medicine, Department of Psychiatry, U.T. Southwestern Medical Center, The Annette Strauss Center for Neuro-Oncology, 5323 Harry Hines Blvd, Dallas, TX 75390-8898, USA.
J Neurooncol. 2005 May;72(3):245-53. doi: 10.1007/s11060-004-3009-z.
Survivors of medulloblastoma, the most frequently occurring malignant brain tumor of childhood, suffer neuropsychological damage in the first decade after diagnosis. Cognitive performance, psychosocial functioning and quality of life were assessed in medulloblastoma survivors in the second decade after diagnosis.
Ten year survivors were evaluated with a battery of neuropsychological tests, and self-report questionnaires regarding quality of life and emotional functioning. Clinical variables examined included the patient's age at diagnosis, duration since diagnosis, treatment, and complications.
Sixteen medulloblastoma survivors [mean age at diagnosis: 7.2 years, range: 1-15 years; 6 males] were tested at a mean age of 22.2 years [range: 13.6-27.9 years]. All survivors had been treated with craniospinal radiation therapy; nine were treated with chemotherapy. Significant impairments were identified in more than 50 of survivors on tests within all neuropsychological domains, including attention, memory, visuospatial abilities, motor functioning, language, and executive functioning. Significant impairments were also identified in all psychosocial domains examined, including employment, ability to drive an automobile, participation in normal education, independent living, and dating history. Most importantly, quality of life scores, reported by both survivors and their caretakers, were in the normal range.
Survivors of childhood medulloblastoma frequently suffer severe persistent deficits in a wide-range of neuropsychological functional domains. Nevertheless, survivors and their families do not report impaired quality of life. These severe neuropsychological and psychosocial deficiencies justify further attempts to reduce or delay the use of craniospinal radiation therapy for childhood medulloblastoma.
髓母细胞瘤是儿童期最常见的恶性脑肿瘤，其幸存者在诊断后的第一个十年会遭受神经心理损伤。本研究评估了髓母细胞瘤幸存者在诊断后的第二个十年的认知表现、心理社会功能和生活质量。
对十年期幸存者进行了一系列神经心理测试，以及关于生活质量和情绪功能的自我报告问卷。检查的临床变量包括患者诊断时的年龄、诊断后的持续时间、治疗情况和并发症。
对16名髓母细胞瘤幸存者[诊断时的平均年龄：7.2岁，范围：1 - 15岁；6名男性]进行了测试，平均年龄为22.2岁[范围：13.6 - 27.9岁]。所有幸存者均接受了颅脊髓放射治疗；9人接受了化疗。在所有神经心理领域的测试中，超过50%的幸存者存在显著损伤，包括注意力、记忆力、视觉空间能力、运动功能、语言和执行功能。在所有检查的心理社会领域也发现了显著损伤，包括就业、驾驶汽车的能力、参与正规教育、独立生活和约会史。最重要的是，幸存者及其照顾者报告的生活质量得分均在正常范围内。
儿童髓母细胞瘤幸存者在广泛的神经心理功能领域经常遭受严重的持续性缺陷。然而，幸存者及其家人并未报告生活质量受损。这些严重的神经心理和心理社会缺陷证明有必要进一步尝试减少或延迟对儿童髓母细胞瘤使用颅脊髓放射治疗。
