辅助治疗后会怎样？辅助治疗后儿童后颅窝恶性肿瘤的生活质量和神经认知功能。
What Happens after Therapy? Quality of Life and Neurocognitive Functions of Children with Malignant Posterior Fossa Tumors after Adjuvant Therapy.
机构信息
Department of Neurosurgery, NIMHANS, Bengaluru, Karnataka, India.
Department of Clinical Psychology, NIMHANS, Bengaluru, Karnataka, India.
出版信息
Neurol India. 2021 Sep-Oct;69(5):1293-1301. doi: 10.4103/0028-3886.329599.
PURPOSE
The health-related quality of life (HRQoL) is an important endpoint in modern clinical practice with improved survival of pediatric posterior fossa malignant brain tumors (PFMBTs). We evaluated the effect of environmental and psychosocial milieu on QoL and cognitive functioning (CF) of Indian children with PFMBT.
METHODS
In a cross-sectional study, 47 children <18 years of age with medulloblastoma or anaplastic ependymoma were evaluated ≥6 months after completion of adjuvant therapy. All clinical and socioeconomic details, educational status of child and family members, socioeconomic status, environmental factors affecting QoL were documented. Children underwent HRQoL evaluation using Pediatric quality of life Inventory (PedsQL) questionnaire and neuropsychological evaluation.
RESULTS
The median age of the cohort at presentation was 7 years (1-18) and median duration of evaluation after adjuvant therapy was 16 months. In 47 families, 72.34% had low monthly income and 76.6% of mothers took formal education. QoL scores were above median values. Parents reported scores highlighted that Lansky performance score (P = 0.001) and maternal education (P = 0.043) significantly influenced the cognitive component of QoL. Twenty-seven children had below-average IQ. Young age at presentation (P = 0.020), maternal education (P = 0.032), high socioeconomic status (P = 0.001) influenced the IQ score. Even though the majority of children (57.44%) had below-average IQ, they had a score of more than 50 on the cognitive functioning scale. A total of 72.5% of the eligible children in our cohort went back to school following therapy, though often with a delay of one academic year.
CONCLUSIONS
Overall cognitive functioning scores of these children are good, but they are not representative of actual neurocognitive tasks based performance or IQ scores. Children should remain under regular follow-up with a neurocognitive assessment and psychological counseling at regular intervals.
目的
儿童后颅窝恶性脑肿瘤（PFMBT）的生存得到改善，健康相关生活质量（HRQoL）成为现代临床实践中的一个重要终点。我们评估了印度 PFMBT 患儿的环境和心理社会环境对生活质量和认知功能（CF）的影响。
方法
在一项横断面研究中，我们对 47 名年龄小于 18 岁、接受辅助治疗后≥6 个月的髓母细胞瘤或间变性室管膜瘤患儿进行了评估。记录了所有临床和社会经济详细信息、儿童和家庭成员的教育状况、社会经济地位、影响生活质量的环境因素。患儿接受了儿童生活质量量表（PedsQL）问卷和神经心理学评估，以评估生活质量。
结果
入组患儿的中位年龄为 7 岁（1-18 岁），辅助治疗后评估的中位时间为 16 个月。在 47 个家庭中，72.34%的家庭月收入较低，76.6%的母亲接受过正规教育。生活质量评分高于中位数。父母报告的评分表明，兰斯基表现评分（P=0.001）和母亲教育程度（P=0.043）显著影响生活质量的认知成分。27 名患儿的智商低于平均水平。发病年龄较小（P=0.020）、母亲教育程度（P=0.032）、高社会经济地位（P=0.001）影响智商评分。尽管大多数患儿（57.44%）的智商低于平均水平，但他们在认知功能量表上的得分超过了 50。我们队列中有 72.5%的符合条件的患儿在治疗后重返学校，尽管通常会延迟一个学年。
结论
这些患儿的整体认知功能评分良好，但不能代表实际神经认知任务的表现或智商评分。儿童应定期接受神经认知评估和心理辅导，以定期进行随访。
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