TY  - JOUR
AU  - Mynarek, Martin
AU  - Rossius, Anne
AU  - Guiard, Anika
AU  - Ottensmeier, Holger
AU  - von Hoff, Katja
AU  - Obrecht-Sturm, Denise
AU  - Bußenius, Lisa
AU  - Friedrich, Carsten
AU  - von Bueren, Andre O
AU  - Gerber, Nicolas U
AU  - Traunwieser, Thomas
AU  - Kortmann, Rolf-Dieter
AU  - Warmuth-Metz, Monika
AU  - Bison, Brigitte
AU  - Thomale, Ulrich-W
AU  - Krauss, Juergen
AU  - Pietsch, Torsten
AU  - Clifford, Steven C
AU  - Pfister, Stefan M
AU  - Sturm, Dominik
AU  - Sahm, Felix
AU  - Tischler, Tanja
AU  - Rutkowski, Stefan
TI  - Risk factors for domain-specific neurocognitive outcome in pediatric survivors of a brain tumor in the posterior fossa - Results of the HIT 2000 trial.
JO  - Neuro-Oncology
VL  - 26
IS  - 11
SN  - 1522-8517
CY  - Oxford
PB  - Oxford Univ. Press
M1  - DKFZ-2024-01206
SP  - 2113-2124
PY  - 2024
N1  - 2024 Nov 4;26(11):2113-2124
AB  - Neurocognition can be severely affected in pediatric brain tumor survivors. We analyzed the association of cognitive functioning with radiotherapy dose, postoperative cerebellar mutism syndrome (pCMS), hydrocephalus, intraventricular methotrexate (MTX) application, tumor localization and biology in pediatric survivors of a posterior fossa tumor.Subdomain-specific neurocognitive outcome data from 279 relapse-free survivors of the HIT-2000 trial (241 medulloblastoma and 38 infratentorial ependymoma) using the Neuropsychological Basic Diagnostic (NBD) tool based on Cattell-Horn-Carroll's model for intelligence were analyzed.Cognitive performance 5.14 years (mean; range=1.52-13.02) after diagnosis was significantly below normal for all subtests. Processing speed and psychomotor abilities were most affected. Influencing factors were domain-specific: CSI-dose had strong impact on most subtests. pCMS was associated with psychomotor abilities (β=-0.25 to -0.16) and processing speed (β=-0.32). Postoperative hydrocephalus correlated with crystallized intelligence (β=-0.20) and short-term memory (β=-0.15), age with crystallized intelligence (β=0.15) and psychomotor abilities (β=-0.16 and β=-0.17). Scores for fluid intelligence (β=-0.23), short-term memory (β=-0.17) and visual processing (β=-0.25) declined, and scores for selective attention improved (β=0.29) with time after diagnosis.Dose of CSI was strongly associated with neurocognitive outcome. Low psychomotor abilities and processing speed both in patients treated with and without CSI suggest a strong contribution of the tumor and its surgery on these functions. Future research therefore should analyze strategies to both reduce CSI-dose and toxicity caused by other treatment modalities.
KW  - Infant (Other)
KW  - ependymoma (Other)
KW  - medulloblastoma (Other)
KW  - neuropsychological late effects (Other)
KW  - quality of survival (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:38835160
DO  - DOI:10.1093/neuonc/noae092
UR  - https://inrepo02.dkfz.de/record/290620
ER  -