Research article
Impairment of intellectual functions after surgery and posterior fossa irradiation in children with ependymoma is related to age and neurologic complications
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* Corresponding author: Jacques Grill grill@igr.fr
1 Department of paediatric and adolescent oncology, Gustave Roussy institute, 39 rue Camille Desmoulins, 94805 Villejuif cedex, France
2 Childrens university hospital Wuerzburg, Josef-Schneider str.2, 97080 Wuerzburg, Germany
3 Ressource center for patients with brain injuries, national rehabilitation hospital, 14 rue du val d'Osne, 94415 Saint-Maurice, France
4 Department of radiotherapy, Gustave Roussy institute, 39 rue Camille Desmoulins, 94805 Villejuif cedex, France
5 Laboratory of psychology and cognitive neurosciences, CNRS-FRE 2987, 71 avenue Edouard Vaillant, 92774 Boulogne-Billancourt, France
BMC Cancer 2008, 8:15 doi:10.1186/1471-2407-8-15
Published: 21 January 2008Abstract
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 ≤ 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.