Cognitive Implications of Ototoxicity in Pediatric Patients With Embryonal Brain Tumors
| Autor: | Sarah Knight, Mary Lynn Chapeiski, Donald J. Mabbott, Carol L. Armstrong, Robyn Boyle, Melanie J. Bonner, Karen D. Evankovich, Shengjie Wu, Jason M. Ashford, Amar Gajjar, Arzu Onar-Thomas, Shawna L. Palmer, Rebecca Beaulieu, Johnnie K. Bass, Traci W. Olivier, Sarah M. Scott, Heather M. Conklin, Jane E. Schreiber, Michelle A. Swain |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Adolescent Hearing loss Audiology 03 medical and health sciences Young Adult 0302 clinical medicine Ototoxicity Original Reports medicine otorhinolaryngologic diseases Humans Prospective Studies Child business.industry Brain Neoplasms Cognition medicine.disease Oncology 030220 oncology & carcinogenesis Child Preschool Female medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | J Clin Oncol |
| ISSN: | 1527-7755 |
| Popis: | PURPOSE Sensorineural hearing loss (SNHL) is associated with intellectual and academic declines in children treated for embryonal brain tumors. This study expands upon existing research by examining core neurocognitive processes that may result in reading difficulties in children with treatment-related ototoxicity. PATIENTS AND METHODS Prospectively gathered, serial, neuropsychological and audiology data for 260 children and young adults age 3 to 21 years (mean, 9.15 years) enrolled in a multisite research and treatment protocol, which included surgery, risk-adapted craniospinal irradiation (average risk, n = 186; high risk, n = 74), and chemotherapy, were analyzed using linear mixed models. Participants were assessed at baseline and up to 5 years after diagnosis and grouped according to degree of SNHL. Included were 196 children with intact hearing or mild to moderate SNHL (Chang grade 0, 1a, 1b, or 2a) and 64 children with severe SNHL (Chang grade 2b or greater). Performance on eight neurocognitive variables targeting reading outcomes (eg, phonemics, fluency, comprehension) and contributory cognitive processes (eg, working memory, processing speed) was analyzed. RESULTS Participants with severe SNHL performed significantly worse on all variables compared with children with normal or mild to moderate SNHL ( P ≤ .05), except for tasks assessing awareness of sounds and working memory. Controlling for age at diagnosis and risk-adapted craniospinal irradiation dose, performance on the following four variables remained significantly lower for children with severe SNHL: phonemic skills, phonetic decoding, reading comprehension, and speed of information processing ( P ≤ .05). CONCLUSION Children with severe SNHL exhibit greater reading difficulties over time. Specifically, they seem to struggle most with phonological skills and processing speed, which affect higher level skills such as reading comprehension. |
| Databáze: | OpenAIRE |
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