Patterns of intellectual development among survivors of pediatric medulloblastoma: A longitudinal analysis
Patterns of intellectual development among survivors of pediatric medulloblastoma: A longitudinal analysis
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DOI：
10.1200/jco.2001.19.8.2302
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发表时间：
2001-04-15
影响因子：
45.3
通讯作者：
Mulhern, RK
中科院分区：
文献类型：
--
作者：
Palmer, SL;Goloubeva, O;Mulhern, RK
目的：为了检验与髓母细胞瘤（MB）治疗儿童的智力丧失相关的两个相互竞争的假设：MB儿童：（1）失去以前学习的技能和信息;或（2）获得新的技能和信息，但与健康同龄人相比，其速度慢于预期。患者和方法：对44例接受术后放疗（XRT）伴或不伴化疗的儿童MB患者进行了评价。完成XRT后，使用儿童版韦氏智力量表进行了150次检查。这些评估提供了一种智力功能的衡量标准，称为估计的全面智商（FSIQ）。年龄校正的患者性能的变化（缩放分数）以及未校正的性能（原始分数）进行了analysed.Results：在最近的检查时，获得的平均估计FSIQ为83.57是一个以上的SD低于预期的人口规范。自XRT被证实以来，认知能力显著下降，平均每年损失2.55个FSIQ点（P =.0001）。对智商（IQ）损失基础的分析显示，自XRT以来，分测验原始得分值随时间显著增加，但增加率低于正常预期，这导致IQ得分下降。这些结果支持了这样一个假设，即MB患者表现出智商值下降，因为他们无法以与健康人相当的速度获得新的技能和信息。同龄人，而不是失去以前获得的信息和技能。(C)2001年，美国临床肿瘤学会。
Purpose: To examine two competing hypotheses relating to intellectual loss among children treated for medulloblastoma (MB): Children with MB either: (1) lose previously learned skills and information; or (2) acquire new skills and information but at a rate slower than expected compared with healthy sameage peers.Patients and Methods: Forty-four pediatric MB patients were evaluated who were treated with postoperative radiation therapy (XRT) with or without chemotherapy. After completion of XRT, a total of 150 examinations were conducted by use of the child version of the Wechsler Intelligence Scales. These evaluations provided a measure of intellectual functioning called the estimated full-scale intelligence quotient (FSIQ). Changes in patient performance corrected for age (scaled scores) as well as the uncorrected performance (raw scores) were analyzed.Results: At the time of the most recent examination, the obtained mean estimated FSIQ of 83.57 was more than one SD below expected population norms. a significant decline in cognitive performance during the time since XRT was demonstrated, with a mean loss of 2.55 estimated FSIQ points per year (P =.0001). An analysis for the basis of the intelligence quotient (IQ) loss revealed that subtest raw score values increased significantly over time since XRT, but the rate of increase was less than normally expected, which resulted in decreased IQ scores.Conclusion: These results support the hypothesis that MB patients demonstrate a decline in IQ values because of an inability to acquire new skills and information at a rate comparable to their healthy same-age peers, as opposed to a loss of previously acquired information and skills. (C) 2001 by American Society of Clinical Oncology.