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@ARTICLE{Mynarek:290620,
author = {M. Mynarek and A. Rossius and A. Guiard and H. Ottensmeier
and K. von Hoff and D. Obrecht-Sturm and L. Bußenius and C.
Friedrich and A. O. von Bueren and N. U. Gerber and T.
Traunwieser and R.-D. Kortmann and M. Warmuth-Metz and B.
Bison and U.-W. Thomale and J. Krauss and T. Pietsch and S.
C. Clifford and S. M. Pfister$^*$ and D. Sturm$^*$ and F.
Sahm$^*$ and T. Tischler and S. Rutkowski},
title = {{R}isk factors for domain-specific neurocognitive outcome
in pediatric survivors of a brain tumor in the posterior
fossa - {R}esults of the {HIT} 2000 trial.},
journal = {Neuro-Oncology},
volume = {26},
number = {11},
issn = {1522-8517},
address = {Oxford},
publisher = {Oxford Univ. Press},
reportid = {DKFZ-2024-01206},
pages = {2113-2124},
year = {2024},
note = {2024 Nov 4;26(11):2113-2124},
abstract = {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.},
keywords = {Infant (Other) / ependymoma (Other) / medulloblastoma
(Other) / neuropsychological late effects (Other) / quality
of survival (Other)},
cin = {B062 / HD01 / B300},
ddc = {610},
cid = {I:(DE-He78)B062-20160331 / I:(DE-He78)HD01-20160331 /
I:(DE-He78)B300-20160331},
pnm = {312 - Funktionelle und strukturelle Genomforschung
(POF4-312)},
pid = {G:(DE-HGF)POF4-312},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:38835160},
doi = {10.1093/neuonc/noae092},
url = {https://inrepo02.dkfz.de/record/290620},
}