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Neuropsychological outcome in children with optic pathway tumours when first-line treatment is chemotherapy


Al Musella's Comments: (This is his personal views and are not necessarily the views of the Musella Foundation!)



Website: http://www.nature.com/cgi-taf/DynaPage.taf?file=/bjc/journal/v89/n11/abs/6601410a.html

Posted on: 11/25/2003

British Journal of Cancer (2003) 89, 2038-2044.

doi:10.1038/sj.bjc.6601410

Neuropsychological outcome in children with optic pathway tumours when first-line treatment is chemotherapy

E Lacaze1,2, V Kieffer1,3, A Streri2, C Lorenzi4, E Gentaz2, J-L Habrand5, G Dellatolas6, C Kalifa1 and J Grill1

1Department of Pediatric and Adolescent Oncology, Gustave Roussy Institute, 39, rue Camille Desmoulins 94805, Villejuif, France

2Laboratory of Cognition and Development, CNRS-UMR 8605, René Descartes University, Henri Piéron Centre, Paris, France

3Centre Ressources, National Hospital of Saint-Maurice, Saint Maurice, France

4Laboratory of Experimental Psychology, CNRS-UMR 8581, René Descartes University, Henri Piéron Centre, Paris, Franace

5Department of Radiotherapy, Gustave Roussy Institute, Villejuif, France

6Laboratory of Epidemiology and Biostatistics, INSERM Unit U472, Villejuif, France

Correspondence to: Dr J Grill, E-mail: grill@igr.fr

Received 1 April 2003; revised 4 August 2003; accepted 12 September 2003

Standard treatment of optic pathways gliomas consists of radiotherapy and surgery when feasible. Owing to the toxicity of irradiation, chemotherapy has emerged as an interesting therapeutic option, especially in young children. This study describes the neuropsychological profile of 27 children (aged between 1.5 and 15.7 years) with optic pathways gliomas treated with chemotherapy as first-line treatment. Eight of them also received radiotherapy as salvage treatment. Eight had neurofibromatosis type 1 (NF1). Intellectual outcome was preserved in children treated with chemotherapy only (mean=107±17) compared to children also receiving radiotherapy (mean IQ=88±24) or children having NF1 and treated with chemotherapy (mean IQ=80±13). Scores for abstract reasoning, mental arithmetic, chessboard/coding, perception, judgement of line orientation were lower in children irradiated than in those treated only by chemotherapy. Children with Nf1 showed subnormal IQ scores with marked impairment of short- and long-term memory. With respect to long-term neuropsychological outcome, our study shows that a chemotherapy-first strategy can preserve the intellectual outcome of these patients either by avoiding the need of radiotherapy or by delaying its use as much as possible.

Keywords: child; neuropsychology; optic pathway glioma; radiotherapy; chemotherapy; visual acuity; blindness




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