Behavioral and educational limitations after chemotherapy for childhood acute lymphoblastic leukemia or Wilms tumor
Behavioral and educational limitations after chemotherapy for childhood acute lymphoblastic leukemia or Wilms tumor
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DOI：
10.1002/cncr.21820
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发表时间：
2006-05-01
期刊：
影响因子：
6.2
通讯作者：
Veerman, AJP
中科院分区：
文献类型：
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作者：
Buizer, AI;de Sonneville, LMJ;Veerman, AJP
背景：儿童癌症预后的改善使得功能结局的监测变得重要。本研究的目的是评估儿童急性淋巴细胞白血病（ALL）或肾母细胞瘤幸存者的行为和教育功能。在本研究中，ALL患儿接受中枢神经系统定向化疗，不进行颅脑照射。方法：在一项多中心研究中，对199名4至18岁儿童的行为功能和学校表现进行了检查。64名儿童因ALL （n = 28）或Wilms肿瘤（11 = 36）完成化疗至少1年。将他们与兄弟姐妹（n = 37）和对照组健康学童（n = 98）进行比较。结果：在ALL患儿中发现行为和教育问题的风险适度增加，但在Wilms肿瘤患儿中没有发现。与同龄儿童相比，ALL儿童在小学的学习成绩较差；然而，特殊教育服务的使用率较低。ALL患儿的教师评价行为和数学成绩与注意功能相关。与标准风险组相比，ALL高危组在学校的问题行为和表现不佳。兄弟姐妹和对照组之间没有发现差异。结论：有证据表明，儿童ALL幸存者存在细微但显著的行为和教育问题，而肾母细胞瘤幸存者没有功能障碍。对仅接受化疗的ALL患儿进行仔细随访是必要的。
BACKGROUND: The improved prognosis of childhood cancer makes monitoring of functional outcome important. The purpose of this Study was to evaluate behavioral and educational functioning in survivors of childhood acute lymphoblastic leukemia (ALL) or a Wilms tumor. In this Study, children with ALL received central nervous system directed chemotherapy without cranial irradiation.METHODS: in a multicenter Study, behavioral functioning and school performance was examined in 199 children age 4 to 18. Sixty-four children were at least 1 year from finishing treatment with chemotherapy for ALL (n = 28) or a Wilms tumor (11 = 36). They were compared with siblings (n = 37) and with a control group of healthy schoolchildren (n = 98).RESULTS: A moderately increased risk of behavioral and educational problems was found in children with ALL but not in children with Wilms tumor. School performance was poorer in children with ALL attending primary school compared with same-age peers; however, the rate of utilization of special education services was low. Teacher-rated behavior and mathematics performance was correlated with attention function in children with ALL. An excess of problem behavior and underperformance at school was found in the ALL high-risk group compared with the standard-risk group. No differences were found between siblings and controls.CONCLUSION: Evidence is provided Of Subtle but significant behavioral and educational problems in survivors of childhood ALL, but no dysfunctions in survivors of a Wilms tumor. Careful follow-up of children with ALL treated with chemotherapy only is warranted.