Peterson Catherine C, Johnson Courtney E, Ramirez Lisa Y, Huestis Samantha, Pai Ahna L H, Demaree Heath A, Drotar Dennis
Division of Child Behavioral Health, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Michigan, USA.
Pediatr Blood Cancer. 2008 Jul;51(1):99-104. doi: 10.1002/pbc.21544.
Mixed findings on the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia (ALL), without radiation, indicate the need for a comprehensive meta-analytic review. The purpose of the current study was to conduct a meta-analysis assessing neuropsychological and academic functioning differences between children with ALL treated solely with chemotherapy and comparison groups.
Thirteen articles met inclusion criteria for the meta-analysis and were analyzed using a random effects model, weighted least squares methods.
Mean effect sizes were significantly different from zero for multiple domains of intelligence and academic achievement; processing speed; verbal memory; and some aspects of executive functioning and fine motor skills, indicating worse functioning in ALL survivors. Effect sizes for visual-motor skills and visual memory were not significantly different from zero.
Results support the presence of neuropsychological and academic sequelae for ALL survivors treated solely with chemotherapy and highlight the need for ongoing follow-up of children with ALL using a standardized neuropsychological test battery and research methodology.
对于未接受放疗的小儿急性淋巴细胞白血病（ALL）单纯化疗治疗的神经心理学后遗症，研究结果不一，这表明需要进行全面的荟萃分析综述。本研究的目的是进行一项荟萃分析，评估单纯接受化疗的ALL患儿与对照组之间的神经心理学和学业功能差异。
13篇文章符合荟萃分析的纳入标准，并采用随机效应模型、加权最小二乘法进行分析。
在多个智力和学业成就领域、处理速度、言语记忆以及执行功能和精细运动技能的某些方面，平均效应量显著不同于零，表明ALL幸存者的功能较差。视觉运动技能和视觉记忆的效应量与零无显著差异。
结果支持单纯接受化疗的ALL幸存者存在神经心理学和学业后遗症，并强调需要使用标准化神经心理学测试组和研究方法对ALL患儿进行持续随访。
