García-Pérez A, Sierrasesumaga L, Narbona-García J, Calvo-Manuel F, Aguirre-Ventalló M
Child Neurology Service, Clinica Universitaria de Navarra, Pamplona, Spain.
Med Pediatr Oncol. 1994;23(2):116-23. doi: 10.1002/mpo.2950230209.
Antineoplastic treatment has a deleterious effect on intellectual functions, which is mainly attributable to radiotherapy. With the object of determining the neuropsychological disturbances associated with brain irradiation in the child, and to try to differentiate them from the effects caused by the other types of treatment (surgical and chemotherapy) as well as from the effects of the tumor itself, a cross-sectional study was carried out in 25 survivors of medial edge intracranial tumors. In order to monitor the effect of systemic chemotherapy on the cognitive functions, and the effect of prolonged absence from school, two control groups were formed, one made up of subjects treated with chemotherapy for extracranial tumors, and the other of patients with non-malignant chronic disease. Neuropsychological functions were measured using the Spanish version of the Wechsler scale, as well as the following tests: Spreen-Benton, ITPA and TALE scales, Yuste Memory Test, Thurstone Attention Test, and the Rey Complex Figure. In addition to a progressive decline found in the full scale intelligence quotient in children irradiated for intracranial tumors, variance analysis showed that these patients deteriorate mainly in visual attention and memory, but also significantly in verbal fluency and in the Performance Intelligence Quotient and all its subtests, when compared to the control groups. Visual attention and the Wechsler Picture Arrangement and Block Designs, were the tests whose decline correlated with the total radiation administered. The article relates this specific neuropsychological injury with the total brain irradiation dose but also with the structures located in the cone-down fields of irradiation to boost regions in the middle edge intracranial content.
抗肿瘤治疗对智力功能有有害影响，这主要归因于放疗。为了确定与儿童脑部放疗相关的神经心理障碍，并试图将其与其他类型治疗（手术和化疗）所引起的影响以及肿瘤本身的影响区分开来，对25例颅内边缘肿瘤幸存者进行了一项横断面研究。为了监测全身化疗对认知功能的影响以及长期缺课的影响，组建了两个对照组，一组由接受颅外肿瘤化疗的受试者组成，另一组由患有非恶性慢性病的患者组成。使用韦氏量表的西班牙语版本以及以下测试来测量神经心理功能：斯普林 - 本顿量表、ITPA和TALE量表、尤斯特记忆测试、瑟斯顿注意力测试以及雷伊复杂图形测试。除了发现接受颅内肿瘤放疗的儿童的全量表智商呈渐进性下降外，方差分析表明，与对照组相比，这些患者主要在视觉注意力和记忆力方面恶化，在言语流畅性、操作智商及其所有子测试方面也有显著恶化。视觉注意力以及韦氏图片排列和积木图案测试，其下降与总辐射剂量相关。本文将这种特定的神经心理损伤与全脑照射剂量以及位于照射缩野至颅内边缘中部区域的结构联系起来。
