Neurodevelopmental status of infants and young children treated for brain tumors with preirradiation chemotherapy

R. K. Mulhern, M. E. Horowitz, E. H. Kovnar, J. Langston, R. A. Sanford, L. E. Kun

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

In an effort to reduce the severity of late neurotoxicities associated with cranial irradiation, 14 infants and young children with malignant brain tumors were given preirradiation chemotherapy for 2 to 22 months (median, 8 months). Prospective neurodevelopmental evaluations were routinely conducted and now extend from 35 to 60 months (median, 41 months) postdiagnosis, and 10 to 52 months (median, 31 months) postirradiation in the 12 surviving children. At the initiation of chemotherapy, less than one fourth of the patients displayed normal performance status or mental functioning on age-corrected tests; the majority remained stable or declined while receiving chemotherapy. Declining mental development and adaptive behavior were noted in six patients following radiation therapy with only two patients now functioning in the normal range for age. The analysis suggests that neurodevelopmental progress is a function of multiple factors, including neurologic and sensorimotor deficits associated with the tumor, surgical intervention, and chemotherapy that antedated radiation therapy. This implies that delaying irradiation will not necessarily improve the patients' functional status. Whether the interval of postponement of irradiation evidenced in this sample will translate into an ultimately better quality of life remains unknown. Given the probable interaction of multiple risk factors, well-controlled prospective clinical trials are needed to definitively analyze this issue.

Original languageEnglish (US)
Pages (from-to)1660-1666
Number of pages7
JournalJournal of Clinical Oncology
Volume7
Issue number11
DOIs
StatePublished - Jan 1 1989

Fingerprint

Brain Neoplasms
Drug Therapy
Radiotherapy
Cranial Irradiation
Psychological Adaptation
Controlled Clinical Trials
Neurologic Manifestations
Reference Values
Quality of Life
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Neurodevelopmental status of infants and young children treated for brain tumors with preirradiation chemotherapy. / Mulhern, R. K.; Horowitz, M. E.; Kovnar, E. H.; Langston, J.; Sanford, R. A.; Kun, L. E.

In: Journal of Clinical Oncology, Vol. 7, No. 11, 01.01.1989, p. 1660-1666.

Research output: Contribution to journalArticle

Mulhern, R. K. ; Horowitz, M. E. ; Kovnar, E. H. ; Langston, J. ; Sanford, R. A. ; Kun, L. E. / Neurodevelopmental status of infants and young children treated for brain tumors with preirradiation chemotherapy. In: Journal of Clinical Oncology. 1989 ; Vol. 7, No. 11. pp. 1660-1666.
@article{9550fb2c7d0f4ecf8e475cf8a3fcf1da,
title = "Neurodevelopmental status of infants and young children treated for brain tumors with preirradiation chemotherapy",
abstract = "In an effort to reduce the severity of late neurotoxicities associated with cranial irradiation, 14 infants and young children with malignant brain tumors were given preirradiation chemotherapy for 2 to 22 months (median, 8 months). Prospective neurodevelopmental evaluations were routinely conducted and now extend from 35 to 60 months (median, 41 months) postdiagnosis, and 10 to 52 months (median, 31 months) postirradiation in the 12 surviving children. At the initiation of chemotherapy, less than one fourth of the patients displayed normal performance status or mental functioning on age-corrected tests; the majority remained stable or declined while receiving chemotherapy. Declining mental development and adaptive behavior were noted in six patients following radiation therapy with only two patients now functioning in the normal range for age. The analysis suggests that neurodevelopmental progress is a function of multiple factors, including neurologic and sensorimotor deficits associated with the tumor, surgical intervention, and chemotherapy that antedated radiation therapy. This implies that delaying irradiation will not necessarily improve the patients' functional status. Whether the interval of postponement of irradiation evidenced in this sample will translate into an ultimately better quality of life remains unknown. Given the probable interaction of multiple risk factors, well-controlled prospective clinical trials are needed to definitively analyze this issue.",
author = "Mulhern, {R. K.} and Horowitz, {M. E.} and Kovnar, {E. H.} and J. Langston and Sanford, {R. A.} and Kun, {L. E.}",
year = "1989",
month = "1",
day = "1",
doi = "10.1200/JCO.1989.7.11.1660",
language = "English (US)",
volume = "7",
pages = "1660--1666",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "11",

}

TY - JOUR

T1 - Neurodevelopmental status of infants and young children treated for brain tumors with preirradiation chemotherapy

AU - Mulhern, R. K.

AU - Horowitz, M. E.

AU - Kovnar, E. H.

AU - Langston, J.

AU - Sanford, R. A.

AU - Kun, L. E.

PY - 1989/1/1

Y1 - 1989/1/1

N2 - In an effort to reduce the severity of late neurotoxicities associated with cranial irradiation, 14 infants and young children with malignant brain tumors were given preirradiation chemotherapy for 2 to 22 months (median, 8 months). Prospective neurodevelopmental evaluations were routinely conducted and now extend from 35 to 60 months (median, 41 months) postdiagnosis, and 10 to 52 months (median, 31 months) postirradiation in the 12 surviving children. At the initiation of chemotherapy, less than one fourth of the patients displayed normal performance status or mental functioning on age-corrected tests; the majority remained stable or declined while receiving chemotherapy. Declining mental development and adaptive behavior were noted in six patients following radiation therapy with only two patients now functioning in the normal range for age. The analysis suggests that neurodevelopmental progress is a function of multiple factors, including neurologic and sensorimotor deficits associated with the tumor, surgical intervention, and chemotherapy that antedated radiation therapy. This implies that delaying irradiation will not necessarily improve the patients' functional status. Whether the interval of postponement of irradiation evidenced in this sample will translate into an ultimately better quality of life remains unknown. Given the probable interaction of multiple risk factors, well-controlled prospective clinical trials are needed to definitively analyze this issue.

AB - In an effort to reduce the severity of late neurotoxicities associated with cranial irradiation, 14 infants and young children with malignant brain tumors were given preirradiation chemotherapy for 2 to 22 months (median, 8 months). Prospective neurodevelopmental evaluations were routinely conducted and now extend from 35 to 60 months (median, 41 months) postdiagnosis, and 10 to 52 months (median, 31 months) postirradiation in the 12 surviving children. At the initiation of chemotherapy, less than one fourth of the patients displayed normal performance status or mental functioning on age-corrected tests; the majority remained stable or declined while receiving chemotherapy. Declining mental development and adaptive behavior were noted in six patients following radiation therapy with only two patients now functioning in the normal range for age. The analysis suggests that neurodevelopmental progress is a function of multiple factors, including neurologic and sensorimotor deficits associated with the tumor, surgical intervention, and chemotherapy that antedated radiation therapy. This implies that delaying irradiation will not necessarily improve the patients' functional status. Whether the interval of postponement of irradiation evidenced in this sample will translate into an ultimately better quality of life remains unknown. Given the probable interaction of multiple risk factors, well-controlled prospective clinical trials are needed to definitively analyze this issue.

UR - http://www.scopus.com/inward/record.url?scp=0024425925&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024425925&partnerID=8YFLogxK

U2 - 10.1200/JCO.1989.7.11.1660

DO - 10.1200/JCO.1989.7.11.1660

M3 - Article

C2 - 2809681

AN - SCOPUS:0024425925

VL - 7

SP - 1660

EP - 1666

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 11

ER -