Uberall M A, Hertzberg H, Meier W, Langer T, Beck J D, Wenzel D
Neuropediatric Department, University Hospital for Children and Adolescents, Erlangen, Germany.
Neuropediatrics. 1996 Aug;27(4):194-6. doi: 10.1055/s-2007-973786.
Visual-evoked potentials (VEPs) were studied in 92 asymptomatic long-term survivors of acute lymphoblastic leukemia (ALL) in first complete remission 6-7 years after cessation of therapy in order to detect therapy-related disturbances in conduction velocity capacities within central nerve fibers. Subjects were grouped with respect to CNS prophylaxis: a) ith. MTX and 18 GY cranial irradiation (group A, n = 58), b) ith. MTX and iv. MHD-MTX, no cranial irradiation (group B, n = 34). At follow-up VEPs were abnormal in 10 subjects (10.9%) with comparable rates in both CNS prophylaxis groups (A: 7/58 [12.1%], B: 3/34 [8.8%]; p = 0.56). Participants with radiological signs of leukodystrophy (n = 14), all within the irradiated CNS prophylaxis group showed significantly prolonged P100 latencies and had a 6.1-fold increased relative risk to develop VEP disturbances. No correlation could be established between VEP outcome and illness- or treatment-related parameters. VEP outcome was not correlated with age at diagnosis or gender. Thus, VEP recordings showed a close relationship with radiation-induced CNS white-matter disturbances. However, their value for clinical practice, routinely performed follow-up evaluations or standardized posttreatment surveillance studies is negligible.
为了检测中枢神经纤维传导速度能力中与治疗相关的紊乱情况，我们对92例急性淋巴细胞白血病（ALL）首次完全缓解且无症状的长期存活者进行了视觉诱发电位（VEP）研究，这些患者在停止治疗6 - 7年后接受检测。根据中枢神经系统预防措施对受试者进行分组：a）接受甲氨蝶呤（MTX）和18 Gy颅脑照射（A组，n = 58），b）接受甲氨蝶呤和静脉注射大剂量甲氨蝶呤（MHD - MTX），未进行颅脑照射（B组，n = 34）。在随访中，10名受试者（10.9%）的VEP异常，两个中枢神经系统预防组的发生率相当（A组：7/58 [12.1%]，B组：3/34 [8.8%]；p = 0.56）。有脑白质营养不良放射学征象的参与者（n = 14），均在接受照射的中枢神经系统预防组中，其P100潜伏期显著延长，发生VEP紊乱的相对风险增加了6.1倍。VEP结果与疾病或治疗相关参数之间未建立相关性。VEP结果与诊断时的年龄或性别无关。因此，VEP记录显示与辐射诱导的中枢神经系统白质紊乱密切相关。然而，它们在临床实践、常规进行的随访评估或标准化的治疗后监测研究中的价值可忽略不计。
