Glauser T A, Packer R J
Division of Child Neurology, Children's Hospital Philadelphia, Pennsylvania.
Childs Nerv Syst. 1991 Feb;7(1):2-12. doi: 10.1007/BF00263824.
Improvements in survival for patients who had childhood brain tumors has led to an increasing emphasis on the quality of life for these long-term survivors. Initial survival studies relied on global descriptions of functional abilities to assess cognitive deficits and reported that from 20% to 40% of long-term survivors had obvious partial disability and less than 10% were severely disabled. Formal neuropsychological testing has revealed that from 40% to 100% of long-term survivors have some form of cognitive deficit in various intelligence quotients, visual/perceptual skills, learning abilities, and adaptive behavior. Prospective, controlled studies have found a younger age at diagnosis, radiotherapy, methotrexate chemotherapy, tumor location and time interval to testing to be important (alone or in combination) and related to a high risk of subsequent cognitive deficits. Some variables play an as yet unresolved role. However, despite the progress of the last decade, future prospective studies are needed to define the role of certain variables in the development of cognitive deficits that maximize survival while minimizing cognitive deficits.
儿童脑肿瘤患者生存率的提高使得人们越来越重视这些长期幸存者的生活质量。最初的生存研究依靠对功能能力的整体描述来评估认知缺陷，并报告称20%至40%的长期幸存者有明显的部分残疾，不到10%为严重残疾。正式的神经心理学测试显示，40%至100%的长期幸存者在各种智商、视觉/感知技能、学习能力和适应性行为方面存在某种形式的认知缺陷。前瞻性对照研究发现，诊断时年龄较小、接受放疗、甲氨蝶呤化疗、肿瘤位置以及测试的时间间隔很重要（单独或综合起来），且与随后出现认知缺陷的高风险相关。一些变量的作用尚未得到解决。然而，尽管在过去十年取得了进展，但仍需要未来的前瞻性研究来确定某些变量在认知缺陷发展中的作用，以便在最大限度提高生存率的同时将认知缺陷降至最低。
