Late complications in childhood central nervous system tumour survivors

被引:60
作者
Anderson, NE [1 ]
机构
[1] Auckland Hosp, Dept Neurol, Auckland, New Zealand
关键词
cerebrovascular disease; obesity; paediatric brain tumours; superficial siderosis; thyroid disease;
D O I
10.1097/00019052-200312000-00006
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose of review As the treatment of childhood brain tumours has improved, long-term survival has become more common. Cognitive, physical and psychological complications of the turnout and its treatment have been recognized more frequently in long-term survivors, This review highlights new studies on the cognitive and endocrine complications in survivors. Less-common late effects of treatment are also discussed. Recent findings Cognitive abnormalities and endocrine dysfunction are the most common complications in long-term survivors. Radiotherapy is the main cause of cognitive dysfunction, but intrathecal methotrexate and surgery are contributory factors. New studies have provided information on the frequency of endocrine complications and risk factors for the development of endocrine disorders. Endocrine complications are uncommon when the turnout has been treated with surgery alone. The risk of developing endocrine dysfunction is increased by radiotherapy, and some studies suggest that chemotherapy has an additional deleterious effect. Primary hypothyroidism may be caused by scattered irradiation from spinal and cranial radiotherapy. Direct involvement of the hypothalamus by the turnout, and hypothalamic damage secondary to surgery or radiotherapy, may cause obesity. Hypothalamic tumours also may be associated with hypersomnolence and other features consistent with narcolepsy. The pathogenesis of hypersomnolence in these patients has not been resolved. Long-term childhood brain-tumour survivors are 40 times more likely to develop a stroke than sibling controls. Superficial siderosis of the central nervous system can develop many years after curative treatment of a cerebellar tumour, but effective treatment for this disorder is not yet available. Summary An attempt to understand the factors that contribute to the long-term morbidity of childhood brain tumours can lead to changes in treatment that improve the quality of life in survivors. Prevention, early recognition and treatment of these complications are attainable goals.
引用
收藏
页码:677 / 683
页数:7
相关论文
共 60 条
[11]   Osteopenia in children surviving brain tumours [J].
Barr, RD ;
Simpson, T ;
Webber, CE ;
Gill, GJ ;
Hay, J ;
Eves, M ;
Whitton, AC .
EUROPEAN JOURNAL OF CANCER, 1998, 34 (06) :873-877
[12]   MOYAMOYA PATTERN OF VASCULAR OCCLUSION AFTER RADIOTHERAPY FOR GLIOMA OF THE OPTIC CHIASM [J].
BEYER, RA ;
PADEN, P ;
SOBEL, DF ;
FLYNN, FG .
NEUROLOGY, 1986, 36 (09) :1173-1178
[13]   PROGRESSIVE CEREBRAL OCCLUSIVE DISEASE AFTER RADIATION-THERAPY [J].
BITZER, M ;
TOPKA, H .
STROKE, 1995, 26 (01) :131-136
[14]   Psychosocial and behavioral functioning among pediatric brain tumor survivors [J].
Carpentieri, SC ;
Meyer, EA ;
Delaney, BL ;
Victoria, ML ;
Gannon, BK ;
Doyle, JM ;
Kieran, MW .
JOURNAL OF NEURO-ONCOLOGY, 2003, 63 (03) :279-287
[15]   Neurocognitive development of children after a cerebellar tumor in infancy: A longitudinal study [J].
Copeland, DR ;
deMoor, C ;
Moore, BD ;
Ater, JL .
JOURNAL OF CLINICAL ONCOLOGY, 1999, 17 (11) :3476-3486
[16]   Obesity in childhood craniopharyngioma: Relation to post-operative hypothalamic damage shown by magnetic resonance imaging [J].
DeVile, CJ ;
Grant, DB ;
Hayward, RD ;
Kendall, BE ;
Neville, BGR ;
Stanhope, R .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1996, 81 (07) :2734-2737
[17]   Long-term outcomes for surgically resected craniopharyngiomas [J].
Duff, JM ;
Meyer, FB ;
Ilstrup, DM ;
Laws, ER ;
Schleck, CD ;
Scheithauer, BW .
NEUROSURGERY, 2000, 46 (02) :291-302
[18]   Second malignancies in young children with primary brain tumors following treatment with prolonged postoperative chemotherapy and delayed irradiation: A Pediatric Oncology Group study [J].
Duffner, PK ;
Krischer, JP ;
Horowitz, ME ;
Cohen, ME ;
Burger, PC ;
Friedman, HS ;
Kun, LE .
ANNALS OF NEUROLOGY, 1998, 44 (03) :313-316
[19]   PROSPECTIVE INTELLECTUAL TESTING IN CHILDREN WITH BRAIN-TUMORS [J].
DUFFNER, PK ;
COHEN, ME ;
PARKER, MS .
ANNALS OF NEUROLOGY, 1988, 23 (06) :575-579
[20]   FACTORS AFFECTING INTELLECTUAL OUTCOME IN PEDIATRIC BRAIN-TUMOR PATIENTS [J].
ELLENBERG, L ;
MCCOMB, JG ;
SIEGEL, SE ;
STOWE, S .
NEUROSURGERY, 1987, 21 (05) :638-644