QOL-34. A FOUR-YEAR FOLLOW-UP STUDY OF NEUROCOGNITION IN CHILDREN TREATED FOR A BRAIN TUMOR

Abstract

Several factors can affect the development of cognitive problems in children treated for a brain tumor. Longitudinal studies with a cognitive assessment after diagnosis can help to disentangle disease and treatment related factors. In the present study we investigated the evolution of neurocognition from diagnosis up to four years later, with a 2-year interval. A total of 32 children diagnosed with a brain tumor at the University Hospitals Leuven were tested with a comprehensive neuropsychological test battery (intelligence, memory, visuomotor functioning and QoL). The first assessment was conducted as soon as possible after diagnosis and before initiation of chemoand/or radiotherapy. Mean age at diagnosis was 8.95 years. Most common diagnoses were pilocytic astrocytoma (n=18) and medulloblastoma (n=8). 37.5% received ventricular drainage and 50% underwent surgery before baseline testing. 21.9% and 28.1% received focal or craniospinal irradiation, respectively. A repeated measures analysis with cranial irradiation (no, focal, craniospinal) as between-subjects factor demonstrated an interaction effect between time and type of irradiation for processing speed (p=0.001). All groups performed equal on baseline and demonstrated a decline. After four years, the group treated with craniospinal irradiation performed worst. Interestingly, a positive time effect was found for general memory functioning (p=0.008), visual learning (p=0.007) and QoL (p=0.002).Processing speed is a vulnerable cognitive function in children treated for a brain tumor, especially if craniospinal irradiation was used. In order to understand the mechanism of decline and improvement of cognitive functions, imaging and longer follow-up studies are required.