Abstract
Background
Late effects of treatment in children diagnosed and treated for brain tumours in infancy is a major concern. Assessment of infants presenting with brain tumours is difficult and there is little information available regarding the development of infants prior to treatment and hence the impact of the tumour itself on developmental outcomes.
Aim
To describe the development of children diagnosed with brain tumours in infancy and to document their cognitive and adaptive function at school entry.
Method
Infants were psychologically evaluated at the time of diagnosis of a brain tumour and during their fifth or sixth year in preparation for school entry.
Results
Children diagnosed with brain tumours in infancy display developmental delays in a number of areas of adaptive function. By the time these children are school age they display further compromise in cognitive and academic skills and adaptive behaviour. Higher levels of deficit at follow-up were associated with tumour location in the supratentorium, younger age at diagnosis and longer time since diagnosis. The effect of radiotherapy could not be determined because of differing degrees of developmental compromise in the treatment groups at baseline.
Conclusion
Brain tumours in infancy confer a risk of poor developmental progress at the time of diagnosis. These children display additional compromise of development by the time they reach school age. Research protocols evaluating the impact of treatment in infants diagnosed with brain tumours need to take account of the developmental status of the child at diagnosis.
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References
Rosenfeld JV, Ashley D (2000) Management of brain tumours in the pediatic patient. In: Kaye AH, Laws ER (eds) Brain tumours, 2nd edn. Churchill Livingston, London
Hoppe-Hirsch E, Renier D, Lelliuch-Tubiana A, Sainte-Rosen C, Pierre-Kahn A, Hirsch JF (1990) Medulloblastoma in childhood: progressive intellectual deterioration. Childs Nerv Syst 6:60–65
Glauser T, Packer RJ (1991) Cognitive deficits in long-term survivors of childhood brain tumours. Childs Nerv Syst 7:2–12
Ris MD, Noll RB (1994) Long-term neurobehavioural outcome in pediatric brain tumour patients: review and methodological critique. J Clin Exp Neuropsychol 16:21–42
Dennis M, Spiegler BJ, Hetherington CR, Greenberg ML (1996) Neuropsychological sequelae of the treatment of children with medulloblastoma. J Neuro-Oncol 29:91–101
Stargatt R, Anderson V, Rosenfeld JV (2002) Neuropsychological outcomes of children treated for posterior fossa tumours: a review. Brain Impair 3(2):92–104
Merchant TE, Lee H, Zhu J, Xiong X, Wheeler G, Phipps S, Boop F, Sandford RA (2004) The effects of hydrocephalus on intelligence quotient in children with localized infratentorial ependymoma before and after focal radiation therapy. J Neurosurg Pediatr 2(101):159–168
Ellenberg L, McComb JG, Siegel SE, Stowe S (1987) Factors affecting intellectual outcome in pediatric brain tumour patients. Neurosurgery 21:638–644
Pompili A, Caperle M, Pace A, Ramazzotti V, Raus L, Jandolo B, Occhipinti E (2002) Quality of life assessment in patients who had been surgically treated for cerebellar pilocytic astrocytoma in childhood. J Neurosurg 96:229–234
Mulhern RK, Horowitz ME, Kovnar EH, Langston J, Sanford RA, Kun LE (1989) Neurodevelopmental status of infants and young children treated for brain tumours with pre-irradiation chemotherapy. J Clin Oncol 7:1660–1666
Anderson V, Smibert E, Ekert H, Godber T (1994) Intellectual, educational, and behavioural sequelae after cranial irradiation and chemotherapy. Arch Dis Child 70(6):476–483
Espy KA, Moore IM, Kaufmann PM, Kramer J, Hutter JJ, Matthay K (1999) Treatment-related change in neuropsychologic function in children with ALL. International Neuropsychological Society, Boston, MA
Espy KA, Moore IM, Kaufmann PM, Kramer JH, Matthay K, Hutter JJ (2001) Chemotherapeutic CNS prophylaxis and neuropsychologic change in children with acute lymphoblastic leukemia: a prospective study. J Pediatr Psychol 26(1):1–9
Kiltie A, Lasford LS, Gattamaneni HR (1997) Survival and late effects in medulloblastoma patients treated with craniospinal irradiation under three years old. Med Pediatr Oncol 28:348–354
Rutkowski S, Bode U, Deinlein F, Ottensmeier H, Warmuth-Metz M, Soerensen N, Graf N, Emser A, Tietsch T, Wolff J, Kortmann R, Kuehl J (2005) Treatment of early childhood medulloblastoma by postoperative chemotherapy alone. N Engl J Med 352(10):978–986
Heideman R, Packer R et’al (1997) Tumours of the central nervous system. In: Poplack PPD (ed) Principles and practice of pediatric oncology. Lippincott-Raven, Philadelphia, p 682
Pfefferbaum-Levine B, Copeland D, Fletcher J, Reid H, Jaffe N, McKinnon W (1984) Neuropsychological assessment of long-term survivors of childhood leukaemia. Am J Pediatr Hematol/Oncol 6:123–128
Hoppe-Hirsch E, Brunet L, Laroussinie F, Cinalli G, Pierr-Kahn A, Renier D, Sainte-Rose C, Hirsch JF (1995) Intellectual outcome in children with malignant tumors of the posterior fossa: influence of the field of irradiation and quality of surgery. Childs Nerv Syst 11(6):340–345
Cousens P, Waters B, Said J, Stevens M (1988) Cognitive effects of cranial irraditation in leukaemia: a survey and meta-analysis. J Child Psychol Psychiatry 29(6):839–852
Danoff B, Cowchock S, Marquette C, Mulgrew L, Kramer S (1982) Assessment of the long-term effects of primary radiation therapy for brain tumors in children. Cancer 49:1580–1586
Packer JR, Sutton LN, Atkins TE, Radcliff J, Bunin GR, D’Angio G, Seigel KR, Schut L (1989) A prospective study of cognitive function in children receiving whole-brain radiotherapy and chemotherapy: 2 year results. J Neurosurg 70:707–713
Jenkin D, Danjoux C, Greenberg M (1998) Subsequent quality of life for children irradiated for a brain tumor before age four years. Med Pediatr Oncol 31:506–511
Duffner PK, Jackson LA, Cohen ME (1996) Neurobehavioral abnormalities resulting from brain tumors and their therapy. CRC Press Inc., pp 289–307
Walter AW, Mulhern RK, Gajjar A, Heideman RL, Reardon D, Sandord RA, Xiong X, Kun L (1999) Survival and neurodevelopmental outcome of young children with medulloblastoma at St Jude Children’s Research Hospital. J Clin Oncol 17(12):3720–3728
Sparrow S, Balla DA, Cichetti DV (1984) Vineland adaptive behaviour scales: interview edition, survey form manual. American Guidance Services, Circle Pines, MN
Wechsler D (1989) Manual for the Wechsler preschool and primary scale of intelligence – revised. The Psychological Corporation, San Antonio
Delis DC, Kramer JH, Kaplan E, Ober BA (1994) Manual for the California verbal learning test – children’s version. The Psychological Corporation, San Antonio
Wechsler D (1992) The manual for the Wechsler individual achievement test. The Psychological Corporation, San Antonio
Korkman M, Kirk U, Kemp S (1998) The manual for the NEPSY: a developmental neuropsychological assessment. The Psychological Corporation, San Antonio
Beery KE, Buktenica NA (1997) The manual for the developmental test of visual-motor integration. Modern Curriculum Press
Tabachnick BG, Fidell LS (2000) Using multivariate statistics, 4th edn. Allyn & Bacon, Boston
Acknowledgements
This project was funded by grants received from the Bluey Day Foundation, Melbourne Australia. Thank you to Ms. Natalie Grapsas, nurse co-ordinator for assistance with organisation of referrals. Most importantly thank you to the children and families who participated.
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Stargatt, R., Rosenfeld, J.V., Anderson, V. et al. Intelligence and adaptive function in children diagnosed with brain tumour during infancy. J Neurooncol 80, 295–303 (2006). https://doi.org/10.1007/s11060-006-9187-0
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DOI: https://doi.org/10.1007/s11060-006-9187-0