Yoo Hee Jung, Kim Hyery, Park Hyeon Jin, Kim Dong Seok, Ra Young Shin, Shin Hee Young
Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Korean Med Sci. 2016 Nov;31(11):1726-1734. doi: 10.3346/jkms.2016.31.11.1726.
The neurocognitive function and quality of life of 58 Korean survivors of childhood medulloblastoma were assessed after surgery, cranial radiation and chemotherapy. All patients were evaluated with a battery of neurocognitive function tests and the Pediatric Functional Assessment of Cancer Therapy-Brain Tumor Survivors, which consists of self-report questionnaires on quality of life. The mean full-scale intelligence quotient (IQ), verbal IQ, and performance IQ scores were 90.2, 97.1, and 84.16, respectively. The mean memory quotient (MQ) score was 86.78, which was within 1 standard deviation of the average score of 100. Processing speed, attention, and executive function showed mild to moderate deficits. Intelligence, memory, executive function, visuospatial function, and simple motor function were significantly lower in the patients diagnosed before 8 years of age compared with those diagnosed after 8. The cognitive deficits in the patients diagnosed at younger ages might be related to earlier exposure to craniospinal irradiation and chemotherapy. The patient and parent proxy evaluations of attention, fine motor function, and quality of life did not differ. We found significant neurocognitive changes in a wide range of neurocognitive functional domains in Korean survivors of childhood medulloblastoma. Long-term follow-up studies of survivors of childhood medulloblastoma beginning at the time of their first diagnosis are required to better understand the deficits exhibited by survivors of childhood medulloblastoma, so that intervention strategies and treatment refinements that reduce the long-term neurocognitive decline can be developed.
对58名韩国儿童髓母细胞瘤幸存者在接受手术、颅脑放疗和化疗后的神经认知功能及生活质量进行了评估。所有患者均接受了一系列神经认知功能测试以及癌症治疗儿童功能评估-脑肿瘤幸存者问卷,该问卷包含关于生活质量的自我报告问题。平均全量表智商(IQ)、言语智商和操作智商得分分别为90.2、97.1和84.16。平均记忆商(MQ)得分为86.78,在平均分100的1个标准差范围内。处理速度、注意力和执行功能表现出轻度至中度缺陷。8岁前确诊的患者在智力、记忆、执行功能、视觉空间功能和简单运动功能方面显著低于8岁后确诊的患者。年幼时确诊患者的认知缺陷可能与更早接受颅脊髓照射和化疗有关。患者及其父母对注意力、精细运动功能和生活质量的代理评估没有差异。我们发现韩国儿童髓母细胞瘤幸存者在广泛的神经认知功能领域存在显著的神经认知变化。需要从首次诊断时开始对儿童髓母细胞瘤幸存者进行长期随访研究,以更好地了解儿童髓母细胞瘤幸存者所表现出的缺陷,从而制定出减少长期神经认知衰退的干预策略和治疗改进方法。