Department of Psychology and Biobehavioral Sciences, St Jude Children's Research Hospital, Memphis, Tennessee, USA.
Department of Psychology, University of Memphis, Memphis, Tennessee, USA.
Pediatr Blood Cancer. 2024 Jul;71(7):e31046. doi: 10.1002/pbc.31046. Epub 2024 Apr 28.
Infancy/toddlerhood is a period of rapid development. All infants/toddlers (0-36 months-of-age) undergoing cancer-directed treatment at one hospital are offered developmental assessments and related services. Yet, literature comparing development of infants/toddlers with brain tumors to those with non-CNS solid tumors is sparse.
Developmental assessment data were abstracted from electronic health records of infants/toddlers undergoing treatment for a brain tumor (n = 36; mean age = 21.83 ± 9.96 months) or a solid tumor (n = 40; mean age = 17.35 ± 8.50). Z-scores compared obtained data with age expectations. Chi-square analyses assessed whether a greater proportion of participants scored within the clinical range than normative expectations. Multivariate analysis of variance and chi-square analyses compared developmental outcomes between groups.
Compared with age expectations, the overall group demonstrated significantly less well-developed skills. Infants/toddlers with solid tumors demonstrated clinical deficits at rates higher than expected for most domains; the rate of impairment for the solid tumor group did not differ significantly from that of the brain tumor group across most subtests.
Like young patients with brain tumors, the developmental functioning of infants/toddlers with solid tumors should be studied across time to determine the trajectory of functioning for these young patients and to inform future developmental intervention studies.
Infants/toddlers with a malignant solid tumor may be at increased risk for delayed development. These very young patients would likely benefit from developmental assessment, early intervention services during and after treatment, and ongoing monitoring of development across time.
婴儿期/学步期是一个快速发展的时期。在一家医院接受癌症定向治疗的所有婴儿/学步儿童(0-36 月龄)都接受发育评估和相关服务。然而,比较患有脑瘤和非中枢神经系统实体瘤的婴儿/学步儿童发育情况的文献很少。
从接受脑瘤(n=36;平均年龄=21.83±9.96 个月)或实体瘤(n=40;平均年龄=17.35±8.50 个月)治疗的婴儿/学步儿童的电子健康记录中提取发育评估数据。Z 分数将获得的数据与年龄预期进行比较。卡方分析评估了有多少参与者的得分在临床范围内而不是在正态预期范围内。采用方差分析和卡方分析比较两组之间的发育结果。
与年龄预期相比,整体组的技能发育明显较差。患有实体瘤的婴儿/学步儿童在大多数领域的临床缺陷率高于预期;实体瘤组的损伤率在大多数子测试中与脑瘤组无显著差异。
与患有脑瘤的年轻患者一样,患有实体瘤的婴儿/学步儿童的发育功能应随着时间的推移进行研究,以确定这些年轻患者的功能轨迹,并为未来的发育干预研究提供信息。
患有恶性实体瘤的婴儿/学步儿童可能有发育迟缓的风险增加。这些非常年幼的患者可能受益于发育评估、治疗期间和治疗后的早期干预服务,以及随着时间的推移对发育的持续监测。