Predicting intellectual outcome among children treated with 35-40 Gy craniospinal irradiation for medulloblastoma.
Fifty children diagnosed with medulloblastoma completed 188 psychological evaluations using the Wechsler Intelligence Scales for Children (D. Wechsler, 1974, 1991) over a 7-year study period following 35-40 Gy postoperative craniospinal irradiation. Random coefficient models were used to predict the trend in the children's intellectual performance as a function of time since diagnosis, with both patient and treatment variables as parameters of this function. A quadratic model demonstrated a delay prior to decline in performance for older patients, whereas the younger patients showed an immediate loss of performance with a plateau at approximately 6 years postdiagnosis. A steeper decline was found for those with higher baseline performance. Clinicians may use the proposed predictive model to identify those patients who are at risk of significant intellectual decline.
Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, TN 38105-2794, USA. shawna.palmer@stjude.org
Shawna L
SL
Palmer
Amar
A
Gajjar
Wilburn E
WE
Reddick
John O
JO
Glass
Larry E
LE
Kun
Shengjie
S
Wu
Xiaoping
X
Xiong
Raymond K
RK
Mulhern
D000293:Adolescent; D017668:Age of Onset; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002528:Cerebellar Neoplasms / Q000188:drug therapy / Q000523:psychology* / Q000532:radiotherapy*; D002648:Child; D004307:Dose-Response Relationship, Radiation; D004493:Education; D005260:Female; D006801:Humans; D007360:Intelligence / Q000528:radiation effects*; D007361:Intelligence Tests; D008137:Longitudinal Studies; D008297:Male; D008527:Medulloblastoma / Q000188:drug therapy / Q000523:psychology* / Q000532:radiotherapy*; D009483:Neuropsychological Tests; D010290:Parents; D011878:Radiotherapy / Q000009:adverse effects*; D018570:Risk Assessment; D012727:Sex Characteristics; D016896:Treatment Outcome
D000970:Antineoplastic Agents