Comparison of neurocognitive and quality-of-life outcomes in pediatric craniopharyngioma patients treated with partial resection and radiotherapy versus gross-total resection only.

Autor:	Aldave G; 1Department of Neurosurgery, Division of Pediatric Neurosurgery, Texas Children's Hospital, Baylor College of Medicine, Houston., Okcu MF; 2Department of Pediatrics, Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston., Chintagumpala M; 2Department of Pediatrics, Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston., Ruggieri L; 1Department of Neurosurgery, Division of Pediatric Neurosurgery, Texas Children's Hospital, Baylor College of Medicine, Houston., Minard CG; 3Dan L. Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, Houston., Malbari F; 4Division of Pediatric Neurology, Texas Children's Hospital, Baylor College of Medicine, Houston., Mash LE; 5Department of Pediatrics, Section of Psychology, Baylor College of Medicine, Houston., Paulino AC; 6Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston; and., McGovern S; 6Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston; and., Ramaswamy U; 7Department of Otorhinolaryngology, Division of Otorhinolaryngology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas., Whitehead W; 1Department of Neurosurgery, Division of Pediatric Neurosurgery, Texas Children's Hospital, Baylor College of Medicine, Houston., Kahalley LS; 2Department of Pediatrics, Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.; 5Department of Pediatrics, Section of Psychology, Baylor College of Medicine, Houston.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Pediatrics [J Neurosurg Pediatr] 2023 Feb 17; Vol. 31 (5), pp. 453-462. Date of Electronic Publication: 2023 Feb 17 (Print Publication: 2023).
DOI:	10.3171/2022.12.PEDS22367
Abstrakt:	Objective: The optimal management of pediatric craniopharyngioma patients remains controversial, shifting from radical resection (gross-total resection [GTR]) to a more conservative approach with partial resection/biopsy followed by radiotherapy (PR+RT). To the authors' knowledge, no previous studies have compared neurocognitive and quality-of-life (QOL) outcomes between the two main treatments. In this study, the authors compared changes in intellectual, adaptive, and QOL scores in children treated for craniopharyngioma with GTR and those treated with PR+RT. Methods: Patients underwent annual neurocognitive and QOL evaluations for up to 10 years posttreatment, including the Full-Scale IQ, Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI), and Processing Speed Index (PSI). Child- and parent-reported QOL scores and adaptive behavior in different domains were assessed. General linear mixed models were used to examine change in scores over time by treatment group with adjustment for significant covariates. Results: Scores from 43 patients treated between 2009 and 2019 (21 GTR, 22 PR+RT) were examined. Within the PR+RT group, 9 patients had intensity-modulated RT and 13 had proton beam therapy. The treatment groups were similar in sex (44% male) and age (median 7.3 years). There were no significant differences in the trajectory of intellectual functioning or QOL scale scores between the two groups. However, patients who underwent GTR exhibited significant improvement over time in overall adaptive behavior (p = 0.04) and conceptual skills (p = 0.01), which was not observed in patients treated with PR+RT. Conclusions: Long-term pediatric craniopharyngioma survivors treated with GTR and PR+RT have similar intellectual function and QOL. Larger studies are needed to explore small but clinically significant differences between the two groups.
Databáze:	MEDLINE
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