Bernáldez-Ríos R, Villasís-Keever M A, Beltrán-Adame G, García-Ramírez R, Rodríguez-Zepeda M C, Hermida-Gutiérrez I, Arias-Gómez J, Cruz-Luna E
Servicio de Hematología Pediátrica, Hospital de Pediatría de Centro Médico Nacional Siglo XXI, México, D.F.
Gac Med Mex. 1998 Mar-Apr;134(2):153-9.
Our objective was to compare the neurologic and psychological sequelae of children with acute lymphoblastic leukemia (ALL) after three or more years without antineoplasic treatment who underwent cranial irradiation plus intrathecal methotrexate (Group 1) or just intrathecal methotrexate (Group 2). In both groups, a neurologic evaluation, electroencephalogram (EEG) and cranial computed tomography (CCT) were performed. Intellectual quotient and the Bender test were done for the psychological evaluation. Investigators did not know the kind of treatment of each patient.
Fisher's exact test and Mann-Whitney U. There were fourteen patients in group 1 and eight patients in group 2. Intellectual quotient was statistically lower in the first group (median 83.5) than in the second (90.5). Neurologic impairments were found in one patient of each group, alterations of the EEG were found in 6 and 4 in group 1 and 2, respectively, and in the CCT of two patients in group 2 without statistical difference. Children with ALL after cranial irradiation have a greater alteration of intellectual performance than children with intrathecal methotrexate. Neurologic alterations were seen in both groups.
我们的目的是比较急性淋巴细胞白血病(ALL)患儿在停止抗肿瘤治疗三年或更长时间后,接受颅脑照射加鞘内注射甲氨蝶呤的患儿(第1组)与仅接受鞘内注射甲氨蝶呤的患儿(第2组)的神经和心理后遗症。两组均进行了神经学评估、脑电图(EEG)和头颅计算机断层扫描(CCT)。通过智商测试和本德尔测试进行心理评估。研究人员不知道每位患者的治疗方式。
采用费舍尔精确检验和曼 - 惠特尼U检验。第1组有14名患者,第2组有8名患者。第1组的智商在统计学上低于第2组(中位数分别为83.5和90.5)。每组各有1名患者出现神经功能障碍,第1组和第2组分别有6例和4例脑电图改变,第2组有2例患者头颅计算机断层扫描有改变,但无统计学差异。接受颅脑照射的ALL患儿比接受鞘内注射甲氨蝶呤的患儿智力表现改变更大。两组均出现了神经学改变。