Remes Tiina M, Hovén Emma, Ritari Niina, Pohjasniemi Heli, Puosi Riina, Arikoski Pekka M, Arola Mikko O, Lähteenmäki Päivi M, Lönnqvist Tuula R I, Ojaniemi Marja K, Riikonen V Pekka, Sirkiä Kirsti H, Winqvist Satu, Rantala Heikki M J, Harila Marika, Harila-Saari Arja H
Department of Pediatrics and Adolescence, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
Department of Child Neurology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Neurooncol Pract. 2021 Jan 22;8(3):266-277. doi: 10.1093/nop/npab004. eCollection 2021 Jun.
Little is known of the cognitive functions, employment, and social status in adult survivors of childhood brain tumor (BT). We aimed to determine the long-term neurocognitive profile of radiotherapy-treated adult survivors of childhood BT and the relationship between cognitive functions and employment and social status.
Neurocognitive profiles of survivors were assessed in a Finnish national cohort of 71 radiotherapy-treated survivors of childhood BT (median follow-up time: 21 years [range: 5-33 years]) using a cross-sectional design. Neurocognitive outcomes were compared to control (n = 45) and normative values. Tumor- and treatment-related data were collected from the patient files. Information on employment and social status was gathered.
Survivors' (median age: 27 years [range: 16-43 years]) median verbal and performance intelligence quotient (IQ) was 90 (range: 49-121) and 87 (range: 43-119), respectively. The cognitive domains with the greatest impairment were executive functions (median score, -3.5 SD [range: -25.0 to 1.3 SD]), and processing speed and attention (median score, -2.5 SD [range: -24.9 to 0.5 SD]). Executive functions were associated with employment, educational level, living independently, having an intimate relationship, and having a driving license. Processing speed and attention were related to educational level, living independently, having an intimate relationship, and having a driving license. Performance IQ was associated with educational level and employment status. Working memory was associated with educational level and living independently.
Radiotherapy-treated adult survivors of childhood BT experience significant neurocognitive impairment, which is associated with difficulties related to employment and social status.
关于儿童脑肿瘤（BT）成年幸存者的认知功能、就业情况和社会地位，人们所知甚少。我们旨在确定接受放疗的儿童BT成年幸存者的长期神经认知概况，以及认知功能与就业和社会地位之间的关系。
采用横断面设计，在芬兰一个全国性队列中对71名接受放疗的儿童BT幸存者（中位随访时间：21年[范围：5 - 33年]）的神经认知概况进行评估。将神经认知结果与对照组（n = 45）及常模值进行比较。从患者病历中收集肿瘤和治疗相关数据。收集有关就业和社会地位的信息。
幸存者（中位年龄：27岁[范围：16 - 43岁]）的言语和操作智商（IQ）中位数分别为90（范围：49 - 121）和87（范围：43 - 119）。受损最严重的认知领域是执行功能（中位得分，-3.5标准差[范围：-25.0至1.3标准差]）、处理速度和注意力（中位得分，-2.5标准差[范围：-24.9至0.5标准差]）。执行功能与就业、教育水平、独立生活、有亲密关系和拥有驾驶执照相关。处理速度和注意力与教育水平、独立生活、有亲密关系和拥有驾驶执照有关。操作IQ与教育水平和就业状况相关。工作记忆与教育水平和独立生活相关。
接受放疗的儿童BT成年幸存者存在明显的神经认知障碍，这与就业和社会地位方面的困难相关。
