Oncology Medical News about Pilocytic astrocytoma, Cognitive deficits, Pediatric patients

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Cognitive deficits and predictors 3 years after diagnosis of a pilocytic astrocytoma in childhood
Journal of Clinical Oncology, 07/20/09

Aarsen FK et al. - Despite normal intelligence at long-term follow-up, children treated for pilocytic astrocytoma (PA) display invalidating cognitive impairments. Adequate treatment of hydrocephalus is important for a more favorable long-term cognitive outcome.

Methods

Aim was to study cognitive deficits and predictors 3 yrs after diagnosis in pts treated for PA
61/67 children were grouped according to infratentorial, supratentorial midline, and supratentorial hemispheric site
Intelligence, memory, attention, language, visual-spatial, and executive functions were assessed
Included predictors were sex, age, relapse, diagnosis-assessment interval, hydrocephalus, kind of treatment, and tumor variables

Results

All children with PA had problems with sustained attention and speed; other problems in different groups:
- Infratentorial group: deficits in verbal intelligence, visual-spatial memory, executive functioning, and naming
- Brainstem tumor group: verbal intelligence and verbal memory problems
- Supratentorial hemispheric tumor group: additional problems with selective attention and executive functioning
- Supratentorial midline tumor group: no extra impairments
- Dorsal supratentorial midline tumor group: problems with language and verbal memory
Predictors for lower cognitive functioning were hydrocephalus, radiotherapy, residual tumor size, and age
Predictors for better functioning were chemotherapy or treatment of hydrocephalus
Almost 60% of children had problems with academic achievement; risk factors were relapse and younger age at diagnosis