Neurocognitive Development of Children After a Cerebellar Tumor in Infancy: A Longitudinal Study

Abstract

PURPOSE: To assess the long-term neuropsychologic effects experienced by children who have tumors in the cerebellum that are diagnosed and treated during infancy. PATIENTS AND METHODS: Twenty-seven children with posterior fossa tumors diagnosed at less than 36 months of age were assessed prospectively with a comprehensive set of age-appropriate tests. Group means and SDs are reported for assessments conducted at diagnosis (analysis 1) and at the most recent follow-up appointment (analysis 2). Cognitive developmental growth curves were derived from the prospective data (analysis 3) using mixed model regression analyses and controlling for age at diagnosis and socioeconomic status. RESULTS: In the first analysis, eight of 11 infants at diagnosis scored within normal limits on all neuropsychologic domains, except for motor skills, which were impaired. In the second analysis, mean scores at the most recent follow-up of 21 of 27 patients were mostly in the normal range; however, group comparisons between those who had (n = 7) and had not (n = 14) been treated with cranial radiation therapy (CRT) showed that patients in the irradiated (CRT) group scored significantly lower than those in the nonirradiated (No-CRT) group on verbal intelligence quotient (IQ) and in the motor domain. In the third analysis (growth curves of CRT and No-CRT groups), statistically significant differences in slope were found on verbal IQ, performance IQ, perceptual-motor skills, language, and attention/executive skills. Slopes on the fine-motor domain were similar; both groups declined at approximately the same rate. CONCLUSION: Neurocognitive development and outcome of children with cerebellar tumors diagnosed in infancy is very positive among those who were treated with surgery and chemotherapy. Declines in performance across time were minimal, and scores tended to remain within normal limits. By itself, a cerebellar tumor in infancy does not seem to have a significant impact on children. However, those who received CRT as part of their treatment are likely to have neurocognitive and psychosocial deficits that require remediational interventions.

Cognitive, educational, psychosocial adjustment and quality of life of children who survive hematopoietic SCT and their siblings

“…Indeed, some studies have found that survivors have more cognitive and educational deficits than their siblings. [5][6][7][8][9] Other studies have found no differences between survivors of childhood cancer and their healthy siblings in behavioral, educational and social problems, as well as feelings of distress, guilt and psychosomatic symptoms. [10][11][12][13] In contrast, in an early study, siblings of childhood cancer survivors showed more distress than the survivors in perceived social isolation; 11 or survivors performed like their siblings in psychological adjustment but did significantly worse than their siblings in educational outcomes.…”

Predicting Change in Academic Abilities After Conformal Radiation Therapy for Localized Ependymoma

“…4 A progressive decline in intellectual functioning after irradiation of larger brain volumes has been well-established. [7][8][9] Academic competence has received less research attention despite being a measure of applied cognitive functioning in a child's natural setting. While IQ and academic performance are correlated in typically developing children, a dissociation in these abilities has been found in certain clinical populations, [10][11][12][13] including cancer survivors.…”

Survivors of Childhood Cancer for More than Twenty Years

“…Especially for tumors of the CNS, the localization, and for other cancer groups the age at diagnosis, lengths of stay in the hospital and total duration of therapy, as well as cranial irradiation, are most likely of major in¯uence. Copeland et al (20) concluded that children with cerebellar tumors and non-irradiation therapy in early infancy have only minimal declines in neurocognitive development compared with patients treated with cranial radiotherapy. Further, this group emphasized the possible late effects of intrathecal chemotherapy (21).…”