Palmer Shawna L, Reddick Wilburn E, Gajjar Amar
Division of Behavioral Medicine, St Jude Children's Research Hospital, Memphis, TN 38105, USA.
J Pediatr Psychol. 2007 Oct;32(9):1040-9. doi: 10.1093/jpepsy/jsl056. Epub 2007 Feb 28.
Risk-adapted treatment approaches employed within contemporary medulloblastoma treatment protocols aim to reduce the neurotoxicity directed at the central nervous system. Despite these important steps to reduce radiation dose exposure, an overwhelming majority of medulloblastoma survivors continue to experience academic failure and significant learning delays.
A review of the current literature is presented.
Deficits in intellectual function, academic achievement, memory, attention, and processing speed are reported. Finally, intervention programs, including pharmacotherapy and experimental cognitive intervention studies, are discussed. A review of neuroimaging studies shows changes in brain tissue following chemotherapy and radiation treatment.
Declining IQ and academic struggles may be predated by difficulties with attention, memory, and processing speed. More clinical trials directed at treating and preventing neurocognitive late effects through cognitive rehabilitation are needed.
当代髓母细胞瘤治疗方案中采用的风险适应性治疗方法旨在降低针对中枢神经系统的神经毒性。尽管采取了这些降低辐射剂量暴露的重要措施，但绝大多数髓母细胞瘤幸存者仍继续经历学业失败和严重的学习延迟。
对当前文献进行综述。
报告了智力功能、学业成绩、记忆、注意力和处理速度方面的缺陷。最后，讨论了包括药物治疗和实验性认知干预研究在内的干预方案。对神经影像学研究的综述显示了化疗和放疗后脑组织的变化。
智商下降和学业困难可能先于注意力、记忆和处理速度方面的困难出现。需要更多针对通过认知康复治疗和预防神经认知迟发效应的临床试验。
