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脑肿瘤患儿的神经认知结局。

Neurocognitive Outcomes in Children with Brain Tumors.

机构信息

Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California, San Francisco, San Francisco, California.

Division of Child Neurology, Department of Neurology, University of California, San Francisco, San Francisco, California.

出版信息

Semin Neurol. 2020 Jun;40(3):315-321. doi: 10.1055/s-0040-1708867. Epub 2020 May 11.

Abstract

Brain tumors are the most common solid tumor in childhood, and although survival outcomes continue to improve, survival is frequently offset by devastating late effects from tumor and treatment. The long-term effects of brain tumors and the therapy necessary to treat them range from sensory and neuroendocrine abnormalities to neurocognitive deficits leading to inferior quality of life. The multifactorial neurocognitive injury is one of the most broadly impacting and challenging late effects to predict and subsequently treat. Certain treatment modalities, such as intrathecal methotrexate and radiation, have been shown to be associated with poor neurocognition; however, long-term outcomes remain highly variable. There are efforts underway to investigate how to better predict, identify, and manage such neurocognitive injury in survivors of pediatric brain tumors. Herein, we focus on the current knowledge of neurocognitive outcomes and potential treatment strategies for this high-risk group.

摘要

脑肿瘤是儿童中最常见的实体肿瘤,尽管生存结果持续改善,但肿瘤和治疗的毁灭性晚期影响经常导致生存质量下降。脑肿瘤的长期影响以及治疗这些肿瘤所需的治疗范围从感觉和神经内分泌异常到导致生活质量下降的认知缺陷。多因素神经认知损伤是最广泛影响和最具挑战性的晚期效应之一,难以预测和随后治疗。某些治疗方式,如鞘内甲氨蝶呤和放疗,已被证明与认知能力下降有关;然而,长期结果仍然高度可变。目前正在努力研究如何更好地预测、识别和管理脑肿瘤儿童幸存者的这种神经认知损伤。在此,我们重点介绍神经认知结果的现有知识和针对这一高危人群的潜在治疗策略。

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