Coutinho Virginie, Dellatolas Georges, Castaignede-Lalande Clemence, Longaud-Vales Audrey, Kieffer Virginie, Guerrini-Rousseau Lea, Grill Jacques, Valteau-Couanet Dominique, Dufour Christelle
Department of Pediatric and Adolescent Oncology, Gustave Roussy.
Neuropediatric Department, Trousseau Hospital, APHP.
J Pediatr Hematol Oncol. 2018 Oct;40(7):e424-e428. doi: 10.1097/MPH.0000000000001200.
The purpose of this study was to evaluate the long-term cognitive sequelae and to describe the neuropsychological profile of patients with intracranial germ cell tumors according to tumor location (pineal or suprasellar site).
Forty-five children treated at Gustave Roussy between 1991 and 2010 were assessed with neuropsychological tests to measure IQ, memory, visuospatial, motor, and executive skills at a mean delay of 4.2 years after diagnosis. All patients have received chemotherapy associated with surgery in 17 cases. Thirty-nine patients received, radiotherapy (focal 27, focal plus ventricles 8, craniospinal 4). Twenty-three patients had 2 IQ assessments with a mean delay of 4.1 years between the first and second.
Full scale IQ was preserved, with higher verbal IQ than other IQ indexes. Visuospatial, fine-motor, and executive difficulties were present in a significant proportion of patients. Visuospatial and fine-motor deficits were significantly associated with oculomotor difficulties, more present in the pineal than in the suprasellar group. No cognitive decline was observed between the first and the second IQ assessment.
Overall cognitive abilities were preserved in children treated for central nervous system germ cell tumor.
本研究旨在评估颅内生殖细胞瘤患者的长期认知后遗症，并根据肿瘤位置（松果体区或鞍上区）描述其神经心理学特征。
对1991年至2010年间在古斯塔夫·鲁西研究所接受治疗的45名儿童进行神经心理学测试，以评估其在诊断后平均4.2年时的智商、记忆力、视觉空间能力、运动能力和执行能力。所有患者均接受了化疗，其中17例患者还接受了手术。39例患者接受了放疗（局部放疗27例，局部加脑室放疗8例，全脑全脊髓放疗4例）。23例患者进行了两次智商评估，第一次和第二次评估之间的平均间隔时间为4.1年。
全量表智商得以保留，言语智商高于其他智商指标。相当一部分患者存在视觉空间、精细运动和执行功能方面的困难。视觉空间和精细运动缺陷与动眼神经功能障碍显著相关，松果体区组比鞍上区组更为常见。在第一次和第二次智商评估之间未观察到认知能力下降。
接受中枢神经系统生殖细胞瘤治疗的儿童总体认知能力得以保留。
