ASSESSMENT OF CLINICAL AND NEUROLOGICAL ALTERATIONS BEFORE RADIATION
THERAPY IN CHILDREN WITH MALIGNANT BRAIN TUMOUR
Abstract
Purpose Young patients with a brain tumour show neurocognitive
alterations as both consequences of the tumour and of the treatments
received. In this paper, we present the basal analysis of a prospective
study of damage from radiation after focal radiation therapy (RT),
correlating tumour localization, symptoms, neurological/endocrinological
impairments, surgery/ies±chemotherapy, and cognitive assessments at the
time of enrolment. Methods Sixty-six children eligible for
focal RT underwent a neurocognitive assessment. The demographic,
pathological and clinical variables with MRI morphological scans, where
differenypt kind of damage scores were defined, were then analysed.
Results The patients’ median age was 8 years; the most frequent
tumour was ependymoma (41%), and the posterior fossa (29%) was the
prevalent site. All but 2 children (with germ cell tumours), had
undergone surgery and 32 sessions of chemotherapy before irradiation.
Ad-hoc scores for neurological deficits and endocre alterations were
created and structural abnormalities were scored in each
cortical/subcortical region. Patients with posterior fossa ependymomas
and infratentorial tumours showed the highest score of neurological
damage while endocrine alterations were more serious in patients with
craniopharyngioma and germ cell tumours of the sellar region and
ventricular system. The median number of structural damaged areas was
equal to 2 for each child. Neurological deficit scores were not
associated with the presence of hydrocephalus and surgery/ies received,
unlike endocrine deficits. Conclusion The analysis of baseline
evaluations highlights damage existing prior to radiation and generated
by multiple factors. In light of these findings, damage over time should
be investigated by distinguishing multiple generating factors.