From: Subject: BioMed Central | Abstract | Impairment of intellectual functions after surgery and posterior fossa irradiation in children with ependymoma is related to age and neurologic complications Date: Fri, 28 Mar 2008 16:37:41 +0100 MIME-Version: 1.0 Content-Type: multipart/related; type="text/html"; boundary="----=_NextPart_000_00A5_01C890F2.0A602E60" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.3198 This is a multi-part message in MIME format. ------=_NextPart_000_00A5_01C890F2.0A602E60 Content-Type: text/html; charset="utf-8" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.biomedcentral.com/1471-2407/8/15/abstract/ =EF=BB=BF BioMed Central | = Abstract | Impairment of intellectual functions after surgery and = posterior fossa irradiation in children with ependymoma is related to = age and neurologic complications
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Research article

Impairment of intellectual functions after surgery and = posterior fossa=20 irradiation in children with ependymoma is related to age and = neurologic=20 complications

Katja von = Hoff1,2=20 ,=20 Virginie Kieffer1,3 ,=20 Jean-Louis Habrand4 ,=20 Chantal Kalifa1 ,=20 Georges Dellatolas5 and = Jacques Grill1

1Department of paediatric and adolescent oncology, = Gustave=20 Roussy institute, 39 rue Camille Desmoulins, 94805 Villejuif = cedex,=20 France

2Childrens university hospital Wuerzburg, = Josef-Schneider=20 str.2, 97080 Wuerzburg, Germany

3Ressource center for patients with brain injuries, = national=20 rehabilitation hospital, 14 rue du val d'Osne, 94415 = Saint-Maurice,=20 France

4Department of radiotherapy, Gustave Roussy = institute, 39=20 rue Camille Desmoulins, 94805 Villejuif cedex, France

5Laboratory of psychology and cognitive = neurosciences,=20 CNRS-FRE 2987, 71 avenue Edouard Vaillant, 92774 = Boulogne-Billancourt,=20 France

=20 author email=20 corresponding author email

BMC Cancer 2008, = 8:15doi:10.1186/1471-2407-8-15

=
Published:21 January 2008

Abstract

Background

To investigate the neuropsychological outcome of children = treated with=20 surgery and posterior fossa irradiation for localized = infratentorial=20 ependymoma.

Methods

23 patients (age 0.3 =E2=80=93 14 years at diagnosis) who were = treated with=20 local posterior fossa irradiation (54 Gy) underwent one (4 = patients) or=20 sequential (19 patients) neuropsychologic evaluation. The last = evaluation=20 was performed at a median of 4.5 (1 to 15.5) years after RT.

Results

Mean last full scale IQ (FSIQ), verbal IQ (VIQ) and PIQ were = 89.1,=20 94.0, and 86.2 respectively. All patients had difficulties with = reading,=20 and individual patients showed deficits in visuospatial, memory = and=20 attentional tasks. There was no trend for deterioration of = intellectual=20 outcome over time. All 5 children with IQ scores =E2=89=A4 75 were = under the age=20 of four at diagnosis. There was a significant association between = the=20 presence of cerebellar deficits and impaired IQ (72.0 vs 95.2, p = <=20 0,001). The absence of hydrocephalus was an indicator of better=20 neuropsychologic outcome (mean FSIQ of 102.6 vs 83.9, p =3D = 0.025).

Conclusion

Within the evaluated cohort, intellectual functions were = moderately=20 impaired. Markedly reduced IQ scores were only seen with early = disease=20 manifestation and treatment, and postoperative neurological = deficits had a=20 strong impact on intellectual = outcome.

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es,status=3Dyes,menubar=3Dyes,copyhistory=3Dyes'); } function loadhalf(width) { var popwidth =3D typeof width !=3D 'undefined'? width+40 : 640; if (popwidth > screen.availWidth) popwidth =3D screen.availWidth; if (popwidth < 640) popwidth =3D 640; window.focus(); window.moveTo(0,0); window.resizeTo(popwidth,screen.availHeight); window.blur; } function loadfull()=20 { window.focus(); window.moveTo(0,0); window.resizeTo(screen.availWidth,screen.availHeight); window.blur; } function loadInParent(link)=20 { if (parent.window.opener.closed) window.open(link); else { parent.window.opener.location =3D link; parent.window.focus(); } } function toggleauthors(auth,button) { try{ var aut=3D document.getElementById(auth); var but =3D document.getElementById(button); if (aut.style.display !=3D "none") { aut.style.display =3D "none"; but.src =3D "/bmcimages/expand2.gif"; } else { aut.style.display =3D "block"; but.src =3D "/bmcimages/contract2.gif"; } } catch(e){} } function andtotext() { document.write(" | Return to text") } function stepback(text) { document.write("" + text + "") } function turn() { if (window.location.hash.length > 0) window.history.back();=20 else window.location=3D"#"; } function goback() { window.history.back();=20 } // Movie embedding. 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getUpdate(typ,pr1,pr2,pid) { if (typ =3D=3D "state") { =09 // Play=20 if (pr1 =3D=3D 2) { =09 // Pause active movie if it is playing. if (currentItem !=3D null && currentItem !=3D pid) { thisMovie(currentItem).sendEvent('playpause'); } =09 // Save current movie currentItem =3D pid;=09 =09 // Flush active movie var on Stop (3) and Pause (0). } else if(pr1 =3D=3D 3 || pr1 =3D=3D 0) { = =20 currentItem =3D null; }=20 } }; // This is a javascript handler for the player and is always needed. function thisMovie(movieName) { if(navigator.appName.indexOf("Microsoft") !=3D -1) { return window[movieName]; } else { return document[movieName]; } }; // Replacing the jpeg with the movie var link =3D true; function playvideo(id,moviename,width,height) { if (document.getElementById) { var flvheight =3D height + 20; var so =3D new = SWFObject('/movies/mediaplayer.swf','js'+id,width,flvheight,'7'); =20 so.useExpressInstall('/movies/expressinstall.swf');=20 so.addParam('allowfullscreen','true'); so.addParam('salign','lt'); so.addParam('quality','high'); so.addParam('scale','noscale'); so.addVariable('file',moviename); =20 so.addVariable('autostart','true'); so.addVariable('showdigits','false'); so.addVariable('useaudio','false'); so.addVariable('usefullscreen','true'); so.addVariable('showicons','false'); so.addVariable('enablejs','true'); so.addVariable('javascriptid','js'+id); = =20 so.addVariable('width',width); so.addVariable('height',flvheight); so.write(id); link =3D false; } } /** * SWFObject v1.5: Flash Player detection and embed - = http://blog.deconcept.com/swfobject/ * * SWFObject is (c) 2007 Geoff Stearns and is released under the MIT = License: * http://www.opensource.org/licenses/mit-license.php * */ if(typeof deconcept=3D=3D"undefined"){var deconcept=3Dnew = Object();}if(typeof = deconcept.util=3D=3D"undefined"){deconcept.util=3Dnew = Object();}if(typeof = deconcept.SWFObjectUtil=3D=3D"undefined"){deconcept.SWFObjectUtil=3Dnew = Object();}deconcept.SWFObject=3Dfunction(_1,id,w,h,_5,c,_7,_8,_9,_a){if(!= document.getElementById){return;}this.DETECT_KEY=3D_a?_a:"detectflash";th= is.skipDetect=3Ddeconcept.util.getRequestParameter(this.DETECT_KEY);this.= params=3Dnew Object();this.variables=3Dnew = Object();this.attributes=3Dnew = Array();if(_1){this.setAttribute("swf",_1);}if(id){this.setAttribute("id"= ,id);}if(w){this.setAttribute("width",w);}if(h){this.setAttribute("height= ",h);}if(_5){this.setAttribute("version",new = deconcept.PlayerVersion(_5.toString().split(".")));}this.installedVer=3Dd= econcept.SWFObjectUtil.getPlayerVersion();if(!window.opera&&document.all&= &this.installedVer.major>7){deconcept.SWFObject.doPrepUnload=3Dtrue;}if(c= ){this.addParam("bgcolor",c);}var = q=3D_7?_7:"high";this.addParam("quality",q);this.setAttribute("useExpress= Install",false);this.setAttribute("doExpressInstall",false);var = _c=3D(_8)?_8:window.location;this.setAttribute("xiRedirectUrl",_c);this.s= etAttribute("redirectUrl","");if(_9){this.setAttribute("redirectUrl",_9);= }};deconcept.SWFObject.prototype=3D{useExpressInstall:function(_d){this.x= iSWFPath=3D!_d?"expressinstall.swf":_d;this.setAttribute("useExpressInsta= ll",true);},setAttribute:function(_e,_f){this.attributes[_e]=3D_f;},getAt= tribute:function(_10){return = this.attributes[_10];},addParam:function(_11,_12){this.params[_11]=3D_12;= },getParams:function(){return = this.params;},addVariable:function(_13,_14){this.variables[_13]=3D_14;},g= etVariable:function(_15){return = this.variables[_15];},getVariables:function(){return = this.variables;},getVariablePairs:function(){var _16=3Dnew Array();var = key;var _18=3Dthis.getVariables();for(key in = _18){_16[_16.length]=3Dkey+"=3D"+_18[key];}return = _16;},getSWFHTML:function(){var = _19=3D"";if(navigator.plugins&&navigator.mimeTypes&&navigator.mimeTypes.l= ength){if(this.getAttribute("doExpressInstall")){this.addVariable("MMplay= 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IsValid(this.getAttribute("version"))){var n=3D(typeof = _20=3D=3D"string")?document.getElementById(_20):_20;n.innerHTML=3Dthis.ge= tSWFHTML();return = true;}else{if(this.getAttribute("redirectUrl")!=3D""){document.location.r= eplace(this.getAttribute("redirectUrl"));}}return = false;}};deconcept.SWFObjectUtil.getPlayerVersion=3Dfunction(){var = _23=3Dnew = deconcept.PlayerVersion([0,0,0]);if(navigator.plugins&&navigator.mimeType= s.length){var x=3Dnavigator.plugins["Shockwave = Flash"];if(x&&x.description){_23=3Dnew = deconcept.PlayerVersion(x.description.replace(/([a-zA-Z]|\s)+/,"").replac= e(/(\s+r|\s+b[0-9]+)/,".").split("."));}}else{if(navigator.userAgent&&nav= igator.userAgent.indexOf("Windows CE")>=3D0){var axo=3D1;var = _26=3D3;while(axo){try{_26++;axo=3Dnew = ActiveXObject("ShockwaveFlash.ShockwaveFlash."+_26);_23=3Dnew = deconcept.PlayerVersion([_26,0,0]);}catch(e){axo=3Dnull;}}}else{try{var = axo=3Dnew = ActiveXObject("ShockwaveFlash.ShockwaveFlash.7");}catch(e){try{var = axo=3Dnew ActiveXObject("ShockwaveFlash.ShockwaveFlash.6");_23=3Dnew = deconcept.PlayerVersion([6,0,21]);axo.AllowScriptAccess=3D"always";}catch= (e){if(_23.major=3D=3D6){return _23;}}try{axo=3Dnew = ActiveXObject("ShockwaveFlash.ShockwaveFlash");}catch(e){}}if(axo!=3Dnull= ){_23=3Dnew deconcept.PlayerVersion(axo.GetVariable("$version").split(" = ")[1].split(","));}}}return = _23;};deconcept.PlayerVersion=3Dfunction(_29){this.major=3D_29[0]!=3Dnull= ?parseInt(_29[0]):0;this.minor=3D_29[1]!=3Dnull?parseInt(_29[1]):0;this.r= ev=3D_29[2]!=3Dnull?parseInt(_29[2]):0;};deconcept.PlayerVersion.prototyp= e.versionIsValid=3Dfunction(fv){if(this.majorfv.major){return = true;}if(this.minorfv.minor){return true;}if(this.rev=3D0;i--){_2f[i].style.display=3D"none";for(var x in = _2f[i]){if(typeof = _2f[i][x]=3D=3D"function"){_2f[i][x]=3Dfunction(){};}}}};if(deconcept.SWF= Object.doPrepUnload){if(!deconcept.unloadSet){deconcept.SWFObjectUtil.pre= 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