Intellectual and functional outcome of children 3 years old or younger who have CNS malignancies

Maryam Fouladi, Elizabeth Gilger, Mehmet Kocak, Dana Wallace, Gray Buchanan, Cara Reeves, Nicole Robbins, Thomas Merchant, Larry E. Kun, Raja Khan, Amar Gajjar, Raymond Mulhern

Research output: Contribution to journalReview article

92 Citations (Scopus)

Abstract

Purpose: To evaluate the impact of tumor location, clinical parameters, and therapy on neurocognitive, neuroendocrine, and functional outcomes in children ≤ 3 years old with intracranial CNS malignancies who survived at least 2 years after diagnosis. Patients and Methods: Records were retrospectively reviewed for 194 children diagnosed from 1985 to 1999 at St Jude Children's Research Hospital (Memphis, TN). Results: The median age at diagnosis was 1.8 years (range, 0.1 to 3.5 years). Median follow-up was 7.64 years (2.0 to 19.4 years). Tumors were infratentorial (102), diencephalic (53), and hemispheric (39); 47% required ventriculoperitoneal shunts, 36% developed seizure disorders, and 20% developed severe ototoxicity. Therapy included no radiation therapy (RT) in 57 (30%), local RT in 87 (45%), and craniospinal irradiation (CSI) in 49 (25%). Overall survival at 10 years was 78 ± 4%. In a longitudinal analysis of 126 patients with at least one neurocognitive evaluation (NE), the mean rate of intelligence quotient (IQ) change for patients who received CSI (-1.34 points per year) and local RT (-0.51 points per year) was significantly different from the no RT group (0.91 points per year; P = .005 and P = .036, respectively). Patients with hemispheric tumors had a significantly greater IQ decline (-1.52 points per year) than those with midline tumors (0.59 points per year; P = .038). Among those with NE ≥ 5 years after diagnosis, 71.4% of CSI recipients compared with 23% of local RT recipients had IQ less than 70 (P = .021). Patients undergoing CSI were more likely to develop endocrinopathies (P < .0001) and to require special education (P = .0007). Conclusion: In young children with CNS tumors, CSI and hemispheric location are associated with significant declines in IQ scores.

Original languageEnglish (US)
Pages (from-to)7152-7160
Number of pages9
JournalJournal of Clinical Oncology
Volume23
Issue number28
DOIs
StatePublished - Dec 1 2005

Fingerprint

Craniospinal Irradiation
Intelligence
Radiotherapy
Neoplasms
Infratentorial Neoplasms
Ventriculoperitoneal Shunt
Special Education
Epilepsy
Survival
Therapeutics
Research

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Fouladi, M., Gilger, E., Kocak, M., Wallace, D., Buchanan, G., Reeves, C., ... Mulhern, R. (2005). Intellectual and functional outcome of children 3 years old or younger who have CNS malignancies. Journal of Clinical Oncology, 23(28), 7152-7160. https://doi.org/10.1200/JCO.2005.01.214

Intellectual and functional outcome of children 3 years old or younger who have CNS malignancies. / Fouladi, Maryam; Gilger, Elizabeth; Kocak, Mehmet; Wallace, Dana; Buchanan, Gray; Reeves, Cara; Robbins, Nicole; Merchant, Thomas; Kun, Larry E.; Khan, Raja; Gajjar, Amar; Mulhern, Raymond.

In: Journal of Clinical Oncology, Vol. 23, No. 28, 01.12.2005, p. 7152-7160.

Research output: Contribution to journalReview article

Fouladi, M, Gilger, E, Kocak, M, Wallace, D, Buchanan, G, Reeves, C, Robbins, N, Merchant, T, Kun, LE, Khan, R, Gajjar, A & Mulhern, R 2005, 'Intellectual and functional outcome of children 3 years old or younger who have CNS malignancies', Journal of Clinical Oncology, vol. 23, no. 28, pp. 7152-7160. https://doi.org/10.1200/JCO.2005.01.214
Fouladi, Maryam ; Gilger, Elizabeth ; Kocak, Mehmet ; Wallace, Dana ; Buchanan, Gray ; Reeves, Cara ; Robbins, Nicole ; Merchant, Thomas ; Kun, Larry E. ; Khan, Raja ; Gajjar, Amar ; Mulhern, Raymond. / Intellectual and functional outcome of children 3 years old or younger who have CNS malignancies. In: Journal of Clinical Oncology. 2005 ; Vol. 23, No. 28. pp. 7152-7160.
@article{c39edaf86a4b48da90f575d52d6cd9d3,
title = "Intellectual and functional outcome of children 3 years old or younger who have CNS malignancies",
abstract = "Purpose: To evaluate the impact of tumor location, clinical parameters, and therapy on neurocognitive, neuroendocrine, and functional outcomes in children ≤ 3 years old with intracranial CNS malignancies who survived at least 2 years after diagnosis. Patients and Methods: Records were retrospectively reviewed for 194 children diagnosed from 1985 to 1999 at St Jude Children's Research Hospital (Memphis, TN). Results: The median age at diagnosis was 1.8 years (range, 0.1 to 3.5 years). Median follow-up was 7.64 years (2.0 to 19.4 years). Tumors were infratentorial (102), diencephalic (53), and hemispheric (39); 47{\%} required ventriculoperitoneal shunts, 36{\%} developed seizure disorders, and 20{\%} developed severe ototoxicity. Therapy included no radiation therapy (RT) in 57 (30{\%}), local RT in 87 (45{\%}), and craniospinal irradiation (CSI) in 49 (25{\%}). Overall survival at 10 years was 78 ± 4{\%}. In a longitudinal analysis of 126 patients with at least one neurocognitive evaluation (NE), the mean rate of intelligence quotient (IQ) change for patients who received CSI (-1.34 points per year) and local RT (-0.51 points per year) was significantly different from the no RT group (0.91 points per year; P = .005 and P = .036, respectively). Patients with hemispheric tumors had a significantly greater IQ decline (-1.52 points per year) than those with midline tumors (0.59 points per year; P = .038). Among those with NE ≥ 5 years after diagnosis, 71.4{\%} of CSI recipients compared with 23{\%} of local RT recipients had IQ less than 70 (P = .021). Patients undergoing CSI were more likely to develop endocrinopathies (P < .0001) and to require special education (P = .0007). Conclusion: In young children with CNS tumors, CSI and hemispheric location are associated with significant declines in IQ scores.",
author = "Maryam Fouladi and Elizabeth Gilger and Mehmet Kocak and Dana Wallace and Gray Buchanan and Cara Reeves and Nicole Robbins and Thomas Merchant and Kun, {Larry E.} and Raja Khan and Amar Gajjar and Raymond Mulhern",
year = "2005",
month = "12",
day = "1",
doi = "10.1200/JCO.2005.01.214",
language = "English (US)",
volume = "23",
pages = "7152--7160",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "28",

}

TY - JOUR

T1 - Intellectual and functional outcome of children 3 years old or younger who have CNS malignancies

AU - Fouladi, Maryam

AU - Gilger, Elizabeth

AU - Kocak, Mehmet

AU - Wallace, Dana

AU - Buchanan, Gray

AU - Reeves, Cara

AU - Robbins, Nicole

AU - Merchant, Thomas

AU - Kun, Larry E.

AU - Khan, Raja

AU - Gajjar, Amar

AU - Mulhern, Raymond

PY - 2005/12/1

Y1 - 2005/12/1

N2 - Purpose: To evaluate the impact of tumor location, clinical parameters, and therapy on neurocognitive, neuroendocrine, and functional outcomes in children ≤ 3 years old with intracranial CNS malignancies who survived at least 2 years after diagnosis. Patients and Methods: Records were retrospectively reviewed for 194 children diagnosed from 1985 to 1999 at St Jude Children's Research Hospital (Memphis, TN). Results: The median age at diagnosis was 1.8 years (range, 0.1 to 3.5 years). Median follow-up was 7.64 years (2.0 to 19.4 years). Tumors were infratentorial (102), diencephalic (53), and hemispheric (39); 47% required ventriculoperitoneal shunts, 36% developed seizure disorders, and 20% developed severe ototoxicity. Therapy included no radiation therapy (RT) in 57 (30%), local RT in 87 (45%), and craniospinal irradiation (CSI) in 49 (25%). Overall survival at 10 years was 78 ± 4%. In a longitudinal analysis of 126 patients with at least one neurocognitive evaluation (NE), the mean rate of intelligence quotient (IQ) change for patients who received CSI (-1.34 points per year) and local RT (-0.51 points per year) was significantly different from the no RT group (0.91 points per year; P = .005 and P = .036, respectively). Patients with hemispheric tumors had a significantly greater IQ decline (-1.52 points per year) than those with midline tumors (0.59 points per year; P = .038). Among those with NE ≥ 5 years after diagnosis, 71.4% of CSI recipients compared with 23% of local RT recipients had IQ less than 70 (P = .021). Patients undergoing CSI were more likely to develop endocrinopathies (P < .0001) and to require special education (P = .0007). Conclusion: In young children with CNS tumors, CSI and hemispheric location are associated with significant declines in IQ scores.

AB - Purpose: To evaluate the impact of tumor location, clinical parameters, and therapy on neurocognitive, neuroendocrine, and functional outcomes in children ≤ 3 years old with intracranial CNS malignancies who survived at least 2 years after diagnosis. Patients and Methods: Records were retrospectively reviewed for 194 children diagnosed from 1985 to 1999 at St Jude Children's Research Hospital (Memphis, TN). Results: The median age at diagnosis was 1.8 years (range, 0.1 to 3.5 years). Median follow-up was 7.64 years (2.0 to 19.4 years). Tumors were infratentorial (102), diencephalic (53), and hemispheric (39); 47% required ventriculoperitoneal shunts, 36% developed seizure disorders, and 20% developed severe ototoxicity. Therapy included no radiation therapy (RT) in 57 (30%), local RT in 87 (45%), and craniospinal irradiation (CSI) in 49 (25%). Overall survival at 10 years was 78 ± 4%. In a longitudinal analysis of 126 patients with at least one neurocognitive evaluation (NE), the mean rate of intelligence quotient (IQ) change for patients who received CSI (-1.34 points per year) and local RT (-0.51 points per year) was significantly different from the no RT group (0.91 points per year; P = .005 and P = .036, respectively). Patients with hemispheric tumors had a significantly greater IQ decline (-1.52 points per year) than those with midline tumors (0.59 points per year; P = .038). Among those with NE ≥ 5 years after diagnosis, 71.4% of CSI recipients compared with 23% of local RT recipients had IQ less than 70 (P = .021). Patients undergoing CSI were more likely to develop endocrinopathies (P < .0001) and to require special education (P = .0007). Conclusion: In young children with CNS tumors, CSI and hemispheric location are associated with significant declines in IQ scores.

UR - http://www.scopus.com/inward/record.url?scp=27244443906&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=27244443906&partnerID=8YFLogxK

U2 - 10.1200/JCO.2005.01.214

DO - 10.1200/JCO.2005.01.214

M3 - Review article

C2 - 16192599

AN - SCOPUS:27244443906

VL - 23

SP - 7152

EP - 7160

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 28

ER -