Hearing loss and intellectual outcome in children treated for embryonal brain tumors: Implications for young children treated with radiation sparing approaches

Autor: Uri Tabori, Vijay Ramaswamy, Donald J. Mabbott, Annie Huang, Normand Laperriere, Sharon L. Cushing, Ute Bartels, Eric Bouffet, Iska Moxon-Emre, Christine Dahl, Vicky Papaioannou
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Hearing aid
Male
Cancer Research
Pediatrics
medicine.medical_treatment
Intelligence
Posterior fossa
chemotherapy
sensorineural hearing loss
Cohort Studies
0302 clinical medicine
Cancer Survivors
Craniospinal Irradiation
Clinical Cancer Researcher
intellectual outcome
Child
RC254-282
Research Articles
Embryonal brain tumors
Brain Neoplasms
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Neoplasms
Germ Cell and Embryonal
pediatric cancer
Memory
Short-Term
Oncology
030220 oncology & carcinogenesis
Child
Preschool
Cohort
Sensorineural hearing loss
Female
medicine.symptom
Comprehension
Research Article
Hydrocephalus
medicine.medical_specialty
Adolescent
Hearing loss
Hearing Loss
Sensorineural
Antineoplastic Agents
Hearing Loss
Unilateral
Hearing Loss
Bilateral
03 medical and health sciences
Chemotherapy-Related Cognitive Impairment
medicine
otorhinolaryngologic diseases
Humans
Radiology
Nuclear Medicine and imaging
Tumor bed
Cognitive Dysfunction
Chemotherapy
Memory Disorders
business.industry
medicine.disease
Pediatric cancer
business
030217 neurology & neurosurgery
Zdroj: Cancer Medicine
Cancer Medicine, Vol 10, Iss 20, Pp 7111-7125 (2021)
ISSN: 2045-7634
Popis: Purpose We investigate the impact of severe sensorineural hearing loss (SNHL) and for the first time evaluate the effect of unilateral versus bilateral SNHL on intellectual outcome in a cohort of children with embryonal brain tumors treated with and without radiation. Methods Data were from 94 childhood survivors of posterior fossa (PF) embryonal brain tumors who were treated with either: (1) chemotherapy alone (n = 16, 7.11 [3.41] years, 11M/5F), (2) standard‐dose craniospinal irradiation (CSI) and/or large boost volumes (n = 44, 13.05 [3.26] years, 29M/15F), or (3) reduced‐dose CSI with a boost restricted to the tumor bed (n = 34, 11.07 [3.80] years, 19M/15F). We compared intellectual outcome between children who: (1) did and did not develop SNHL and (2) developed unilateral versus bilateral SNHL. A Chang grade of ≥2b that required the use of a hearing aid was considered severe SNHL. Comparisons were made overall and within each treatment group separately. Results Patients who developed SNHL had lower full scale IQ (p = 0.007), verbal comprehension (p = 0.003), and working memory (p = 0.02) than patients without SNHL. No differences were observed between patients who had unilateral versus bilateral SNHL (all p > 0.05). Patients treated with chemotherapy alone who developed SNHL had lower mean working memory (p = 0.03) than patients who did not develop SNHL. Among patients treated with CSI, no IQ indices differed between those with and without SNHL (all p > 0.05). Conclusions Children treated for embryonal brain tumors who develop severe SNHL have lower intellectual outcome than patients with preserved hearing: this association is especially profound in young children treated with radiation sparing approaches. We also demonstrate that intellectual outcome is similarly impaired in patients who develop unilateral versus bilateral SNHL. These findings suggest that early intervention to preserve hearing is critical.
Databáze: OpenAIRE
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