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Neurocognitive outcomes in pediatric and adolescent patients with central nervous system germinoma treated with a strategy of chemotherapy followed by reduced‐dose and volume irradiation
Author(s) -
O'Neil Sharon,
Ji Lingyun,
Buranahirun Cathliyn,
Azoff Jaye,
Dhall Girish,
Khatua Soumen,
Patel Sunita,
Panigrahy Ashok,
Borchert Mark,
Sposto Richard,
Finlay Jonathan
Publication year - 2011
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.23146
Subject(s) - neurocognitive , medicine , germinoma , neuropsychology , pediatrics , nonverbal communication , verbal memory , neuropsychological assessment , chemotherapy , cognition , surgery , psychiatry , psychology , developmental psychology
Background Evaluation of neurocognitive outcomes after a treatment strategy of chemotherapy followed by reduced‐dose and volume irradiation for primary central nervous system (CNS) germinoma. Methods Neuropsychological evaluations including measures of verbal and nonverbal intellectual functioning, working memory, processing speed, verbal and nonverbal memory, executive functioning, depression, anxiety, and social functioning were analyzed for all patients (N = 20) with histologically diagnosed CNS germinoma diagnosed at our institution between 2003 and 2009. All 20 patients underwent at least one neuropsychological evaluation, 14 patients had at least two evaluations, 7 patients had at least three, and 2 had four, generating a total of 43 test batteries at a mean of 3.0 years from diagnosis. Results The 20 patients performed as a group in the average range on all neurocognitive measures administered when compared to the nonmedical normative group. No decline over time was indicated on any of the neurocognitive measures. An improvement over time was indicated for nonverbal reasoning, nonverbal memory, processing speed, working memory, response inhibition, and cognitive flexibility. No significant differences were found by tumor location, age at diagnosis, or hydrocephalus at presentation. Conclusions For pediatric and adolescent patients with newly diagnosed CNS germinoma, modest chemotherapy followed by reduced dose ventricular field irradiation with simultaneous integrated boost to the primary site, is associated with preservation of neurocognitive, social and emotional functioning. Pediatr Blood Cancer 2011; 57: 669–673. © 2011 Wiley‐Liss, Inc.