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使用神经预测量表和儿科神经肿瘤治疗强度评分预测儿科脑肿瘤幸存者的神经认知晚期效应。

Predicting neuropsychological late effects in pediatric brain tumor survivors using the Neurological Predictor Scale and the Pediatric Neuro-Oncology Rating of Treatment Intensity.

机构信息

The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

LifeStance Health, Northborough, MA, USA.

出版信息

J Int Neuropsychol Soc. 2024 May;30(4):380-388. doi: 10.1017/S1355617723000589. Epub 2023 Sep 25.

DOI:10.1017/S1355617723000589
PMID:37746790
Abstract

OBJECTIVE

The Neurological Predictor Scale (NPS) quantifies cumulative exposure to tumor- and treatment-related neurological risks. The Pediatric Neuro-Oncology Rating of Treatment Intensity (PNORTI) measures the intensity of different treatment modalities, but research is needed to establish whether it is associated with late effects. This study evaluated the predictive validity of the NPS and PNORTI for neuropsychological outcomes in pediatric brain tumor survivors.

METHOD

A retrospective chart review was completed of pediatric brain tumor survivors (PBTS) ( = 161, = 13.47, = 2.80) who were at least 2 years from the end of tumor-directed treatment. Attention, intellectual functioning, perceptual reasoning, processing speed, verbal reasoning, and working memory were analyzed in relation to the NPS and PNORTI.

RESULTS

NPS scores ranged from 1 to 11 ( = 5.57, = 2.27) and PNORTI scores ranged from 1 ( = 101; 62.7%) to 3 ( = 18; 11.2%). When controlling for age, sex, SES factors, and time since treatment, NPS scores significantly predicted intellectual functioning [(7,149) = 12.86, < .001, = .38] and processing speed [(7,84) = 5.28, < .001, = .31]. PNORTI scores did not significantly predict neuropsychological outcomes.

CONCLUSIONS

The findings suggest that the NPS has value in predicting IF and processing speed above-and-beyond demographic variables. The PNORTI was not associated with neuropsychological outcomes. Future research should consider establishing clinical cutoff scores for the NPS to help determine which survivors are most at risk for neuropsychological late effects and warrant additional assessment.

摘要

目的

神经预测量表(NPS)量化了肿瘤和治疗相关的神经风险的累积暴露。儿科神经肿瘤治疗强度评分(PNORTI)衡量了不同治疗方式的强度,但需要研究它是否与晚期效应相关。本研究评估了 NPS 和 PNORTI 对儿科脑肿瘤幸存者神经心理学结果的预测有效性。

方法

对至少在肿瘤治疗结束后 2 年的儿科脑肿瘤幸存者(PBTS)(n = 161,M = 13.47,SD = 2.80)进行了回顾性图表审查。分析了注意力、智力功能、感知推理、加工速度、言语推理和工作记忆与 NPS 和 PNORTI 的关系。

结果

NPS 评分范围为 1 至 11(M = 5.57,SD = 2.27),PNORTI 评分范围为 1(n = 101;62.7%)至 3(n = 18;11.2%)。在控制年龄、性别、SES 因素和治疗后时间后,NPS 评分显著预测智力功能[(7,149)= 12.86,<.001,=.38]和加工速度[(7,84)= 5.28,<.001,=.31]。PNORTI 评分与神经心理学结果无显著相关性。

结论

这些发现表明,NPS 在预测 IF 和加工速度方面具有价值,超过了人口统计学变量。PNORTI 与神经心理学结果无关。未来的研究应考虑为 NPS 建立临床临界分数,以帮助确定哪些幸存者最有患神经心理学晚期效应的风险,并需要进一步评估。

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