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Patterns of neuropsychological deficits in children with medulloblastoma according to craniospatial irradiation doses

Published online by Cambridge University Press:  16 November 2000

Virginie Kieffer-Renaux
Affiliation:
Department of Pediatric Oncology, Gustave Roussy Institute, Villejuif, France.
Christine Bulteau
Affiliation:
Department of Pediatric Oncology, Gustave Roussy Institute, Villejuif, France.
Jacques Grill
Affiliation:
Department of Pediatric Oncology, Gustave Roussy Institute, Villejuif, France.
Chantal Kalifa
Affiliation:
Department of Pediatric Oncology, Gustave Roussy Institute, Villejuif, France.
Delphine Viguier
Affiliation:
Epidémiologie et Biostatistiques, INSERM U472, Villejuif, France.
Isabelle Jambaque
Affiliation:
Neuropsychology Unit, Department of Neuropediatrics, Saint-Vincent de Paul Hospital, Paris, France.
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Abstract

This study aimed to analyse the relationship between supratentorial irradiation dose and the intellectual outcome in 36 children (aged between 5 and 15 years) treated for medulloblastoma. The supratentorial radiation dose was reduced to 25Gy in 23 children and given at the standard dose, 35Gy, in 13 other children. Neuropsychological evaluation was performed at a mean of 4.3 years (SD 4.7 years) after radiotherapy. The supratentorial radiation dose was the principal risk factor associated with impaired intellectual outcome. Verbal fluency, immediate word list recall, block design, and fine motricity of the dominant hand were significantly lower in children irradiated at the standard doses than in those irradiated at reduced doses. These findings suggest that the dose of radiotherapy applied to the brain strongly influences later verbal and non-verbal skills in children with medulloblastoma. This should be taken into account in treatment planning and in rehabilitation programs.

Type
Original Articles
Copyright
2000 Mac Keith Press

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