Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Jan 21:8:15.
doi: 10.1186/1471-2407-8-15.

Impairment of intellectual functions after surgery and posterior fossa irradiation in children with ependymoma is related to age and neurologic complications

Katja von Hoff  1 , Virginie Kieffer, Jean-Louis Habrand, Chantal Kalifa, Georges Dellatolas, Jacques Grill
Affiliations

Impairment of intellectual functions after surgery and posterior fossa irradiation in children with ependymoma is related to age and neurologic complications

Katja von Hoff et al. BMC Cancer. .

Abstract

Background: To investigate the neuropsychological outcome of children treated with surgery and posterior fossa irradiation for localized infratentorial ependymoma.

Methods: 23 patients (age 0.3 - 14 years at diagnosis) who were treated with local posterior fossa irradiation (54 Gy) underwent one (4 patients) or sequential (19 patients) neuropsychologic evaluation. The last evaluation was performed at a median of 4.5 (1 to 15.5) years after RT.

Results: Mean last full scale IQ (FSIQ), verbal IQ (VIQ) and PIQ were 89.1, 94.0, and 86.2 respectively. All patients had difficulties with reading, and individual patients showed deficits in visuospatial, memory and attentional tasks. There was no trend for deterioration of intellectual outcome over time. All 5 children with IQ scores < or = 75 were under the age of four at diagnosis. There was a significant association between the presence of cerebellar deficits and impaired IQ (72.0 vs 95.2, p < 0,001). The absence of hydrocephalus was an indicator of better neuropsychologic outcome (mean FSIQ of 102.6 vs 83.9, p = 0.025).

Conclusion: Within the evaluated cohort, intellectual functions were moderately impaired. Markedly reduced IQ scores were only seen with early disease manifestation and treatment, and postoperative neurological deficits had a strong impact on intellectual outcome.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Reading performances. Differences between chronological age and reading age in years of 12 patients at different time points after therapy (4 had one test, 8 had sequential testing); Results of individual patients are connected with lines.
Figure 2
Figure 2
Of ten patients with age < 5 years at diagnosis, eight were irradiated before the age of 5. Regression line is also indicated (r = 0.22; p = 0.3). Black circles = patients > 5 y at diagnosis. Red circles = patients < 5 y at diagnosis.
Figure 3
Figure 3
FSIQ of the 23 patients at different time points after RT. Results of individual patients are connected with lines.
Figure 4
Figure 4
FSIQ with absent (n = 16) and present (n = 6) cerebellar syndrome (CS) at time of neuropsychological evaluation. Representation of the results is given as a Tukey and Cleveland's box-plot. The box represents the 5 principal centiles, ie 50% of the distribution. The line in the middle of the box represents the median. The line on top of the box joins the 90th centile. The line below the box joins the 10th percentile. Circles indicate the extreme values.
See this image and copyright information in PMC

References

    1. Kaatsch P, Rickert CH, Kuhl J, Schuz J, Michaelis J. Population-based epidemiologic data on brain tumors in German children. Cancer. 2001;92:3155–3164. doi: 10.1002/1097-0142(20011215)92:12<3155::AID-CNCR10158>3.0.CO;2-C. - DOI - PubMed
    1. Perilongo G, Massimino M, Sotti G, Belfontali T, Masiero L, Rigobello L, Garre L, Carli M, Lombardi F, Solero C, Sainati L, Canale V, del Prever AB, Giangaspero F, Andreussi L, Mazza C, Madon E. Analyses of prognostic factors in a retrospective review of 92 children with ependymoma: Italian Pediatric Neuro-oncology Group. Med Pediatr Oncol. 1997;29:79–85. doi: 10.1002/(SICI)1096-911X(199708)29:2<79::AID-MPO3>3.0.CO;2-O. - DOI - PubMed
    1. Merchant TE, Mulhern RK, Krasin MJ, Kun LE, Williams T, Li C, Xiong X, Khan RB, Lustig RH, Boop FA, Sanford RA. Preliminary results from a phase II trial of conformal radiation therapy and evaluation of radiation-related CNS effects for pediatric patients with localized ependymoma. J Clin Oncol. 2004;22:3156–3162. doi: 10.1200/JCO.2004.11.142. - DOI - PubMed
    1. Horn B, Heideman R, Geyer R, Pollack I, Packer R, Goldwein J, Tomita T, Schomberg P, Ater J, Luchtman-Jones L, Rivlin K, Lamborn K, Prados M, Bollen A, Berger M, Dahl G, McNeil E, Patterson K, Shaw D, Kubalik M, Russo C. A multi-institutional retrospective study of intracranial ependymoma in children: identification of risk factors. J Pediatr Hematol Oncol. 1999;21:203–211. doi: 10.1097/00043426-199905000-00008. - DOI - PubMed
    1. van Veelen-Vincent ML, Pierre-Kahn A, Kalifa C, Sainte-Rose C, Zerah M, Thorne J, Renier D. Ependymoma in childhood: prognostic factors, extent of surgery, and adjuvant therapy. J Neurosurg. 2002;97:827–835. - PubMed

MeSH terms

LinkOut - more resources