Packer R J, Sposto R, Atkins T E, Sutton L N, Bruce D A, Siegel K R, Rorke L B, Littman P A, Schut L
Division of Neurology, Children's Hospital of Philadelphia, Philadelphia.
Pediatr Neurosci. 1987;13(4):169-75. doi: 10.1159/000120325.
We reviewed our experience in 43 consecutive patients with primitive neuroectodermal tumors (medulloblastoma), PNET (MB), treated between 1975 and 1984, to characterize their quality of life and identify factors which impacted on long-term function. Twenty-four of forty-three (56%) of children are alive and free of disease, a median of 4.5 years after diagnosis. The quality of life was analyzed for the 24 long-term survivors. 79% (19 of 24) were functioning well in everyday activities. The median full-scale intelligence quotient (FSIQ), obtained a median of 3.5 years after diagnosis for those tested (n = 17) was 97, with all but 3 (12%) of the patients functioning in the normal range. Specific learning, memory and fine-motor disabilities were found in over one half of patients. Factors associated with poorer performance and lower FSIQ included preoperative obtundation, the need for a permanent shunt, younger age at diagnosis, and a complicated postoperative course. It is concluded that (1) the majority of long-term survivors have 'normal' intellectual function, but may have specific intellectual and academic disabilities, and (2) preoperative and postoperative factors strongly impact on the quality of life of survivors.
我们回顾了1975年至1984年间连续收治的43例原始神经外胚层肿瘤(髓母细胞瘤)患者的治疗经验,以描述他们的生活质量并确定影响长期功能的因素。43例儿童中有24例(56%)存活且无疾病,诊断后中位时间为4.5年。对这24例长期存活者的生活质量进行了分析。79%(24例中的19例)在日常活动中功能良好。对接受测试的患者(n = 17)在诊断后中位时间3.5年时获得的全量表智商(FSIQ)中位数为97,除3例(12%)外,所有患者的功能均在正常范围内。超过一半的患者存在特定的学习、记忆和精细运动障碍。与表现较差和FSIQ较低相关的因素包括术前意识模糊、需要永久性分流、诊断时年龄较小以及术后病程复杂。得出的结论是:(1)大多数长期存活者具有“正常”的智力功能,但可能存在特定的智力和学业障碍;(2)术前和术后因素对存活者的生活质量有强烈影响。