Department of Pediatrics Division of Pediatric Hematology-Oncology, Baskent University, Adana, Turkey.
Department of Child and Adolescent Psychiatry, Baskent University, Adana, Turkey.
Childs Nerv Syst. 2024 Feb;40(2):417-425. doi: 10.1007/s00381-023-06146-1. Epub 2023 Sep 12.
Medulloblastoma is one of the brain tumors with increased life expectancy due to improvements in treatment approaches. Besides the promising results, various undesirable effects can be encountered. This study's aim is to review long-term follow-up outcomes of our cases with medulloblastoma.
Age at diagnosis, histological type of medulloblastoma, resection extension, chemotherapy and radiotherapy schemes, follow-up duration, and endocrinological, neuropsychiatric, cardiological, auditory, and visual examination results were evaluated in 20 patients diagnosed between 2007 and 2018 and followed 5 years and more.
Twenty of 53 patients were included to the study. Eleven (55%) were male. Mean age at diagnosis was 6.95 years; mean age at the time of the study was 14 years. Mean follow-up time was 8.95 years. In terms of surgery, 14 (70%) were gross total, 1 (5%) was near total, and 2 (10%) were subtotal resection. In histopathological examination, 14 (70%) were classical medulloblastoma, 4 (20%) were desmoplastic medulloblastoma, and 1 (5%) was anaplastic medulloblastoma. With regard to endocrinological evaluation, 15 (75%) patients had hypothyroidism, 5 (25%) had growth hormone deficiency, 7 (35%) had clinical growth hormone deficiency, and 5 (25%) had sex hormone disorders. In neuropsychiatric examination, 11 (55%) patients had neurological sequelae, 18 (90%) patients had psychiatric issues, and 14 (70%) patients had two or more neuropsychiatric problems simultaneously. One (5%) patient had mitral valve insufficiency. Twelve patients (60%) had hearing loss. According to visual examination, 6 (30%) patients had refraction problem, 4 (20%) had cataract, and 1 (5%) had dry eye.
Careful monitoring of long-term side effects is important for improving the quality of life of medulloblastoma patients. Besides endocrinological and other somatic sequelae of the disease and treatment, increased neuropsychiatric problems showed us that only cure is not the issue while treating childhood medulloblastoma.
由于治疗方法的改进，髓母细胞瘤是预期寿命延长的脑肿瘤之一。除了有希望的结果外，还可能遇到各种不良影响。本研究旨在回顾我们的髓母细胞瘤病例的长期随访结果。
评估了 2007 年至 2018 年间诊断的 20 例患者的年龄、髓母细胞瘤的组织学类型、切除范围、化疗和放疗方案、随访时间以及内分泌、神经精神、心脏、听觉和视觉检查结果，随访时间超过 5 年。
20 例 53 例患者纳入研究。11 例（55%）为男性。诊断时的平均年龄为 6.95 岁；研究时的平均年龄为 14 岁。平均随访时间为 8.95 年。在手术方面，14 例（70%）为大体全切除，1 例（5%）为近全切除，2 例（10%）为次全切除。在组织病理学检查中，14 例（70%）为经典髓母细胞瘤，4 例（20%）为促纤维增生性髓母细胞瘤，1 例（5%）为间变性髓母细胞瘤。在内分泌评估方面，15 例（75%）患者患有甲状腺功能减退症，5 例（25%）患者生长激素缺乏症，7 例（35%）患者有临床生长激素缺乏症，5 例（25%）患者有性激素紊乱。在神经精神检查中，11 例（55%）患者有神经系统后遗症，18 例（90%）患者有精神问题，14 例（70%）患者同时有两个或更多的神经精神问题。1 例（5%）患者有二尖瓣关闭不全。12 例（60%）患者有听力损失。根据视觉检查，6 例（30%）患者有屈光不正问题，4 例（20%）患者有白内障，1 例（5%）患者有干眼症。
仔细监测长期副作用对于提高髓母细胞瘤患者的生活质量非常重要。除了疾病和治疗的内分泌和其他躯体后遗症外，神经精神问题的增加也表明，在治疗儿童髓母细胞瘤时，仅治愈并不是问题。
