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Neurocognitive and Psychological Functioning of Children with an Intracranial Germ Cell Tumor
Younghee Park1,2, Eun-Seung Yu3, Boram Ha1
1Proton Therapy Center, National Cancer Center, Goyang, Korea.
Insights
Children with intracranial germ cell tumors (IGCT) show impaired neurocognitive function, particularly with basal ganglia tumors. Neuropsychological function requires monitoring from diagnosis, as early changes after proton beam therapy (PBT) are not significant.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Neuropsychology
Background:
- Intracranial germ cell tumors (IGCT) are rare pediatric neoplasms.
- Neurocognitive deficits are a known complication in pediatric cancer survivors.
- Understanding pre-treatment neurocognitive status is crucial for managing IGCT patients.
Purpose of the Study:
- To assess neurocognitive functioning in children with IGCT before proton beam therapy (PBT).
- To identify how tumor location influences neurocognitive deficits in IGCT.
- To evaluate early changes in neurocognitive function 1-2 years post-PBT.
Main Methods:
- 34 children with IGCT treated with PBT were assessed using standardized neurocognitive tests.
- Baseline psychological assessment included the Child Behavior Checklist (CBCL).
- Tumor locations (suprasellar, pineal, basal ganglia, bifocal) were analyzed for differential impact.
Main Results:
- IGCT patients exhibited significantly lower performance IQ, processing speed, memory, and executive functioning compared to controls.
- Basal ganglia tumors were associated with the most severe neurocognitive deficits and higher CBCL scores.
- No significant neurocognitive changes were observed between baseline and 1-2 years post-PBT.
Conclusions:
- Tumor location is a significant determinant of neuropsychological functioning in pediatric IGCT.
- Close neurocognitive monitoring is essential for IGCT patients from the time of diagnosis.
- Early post-PBT neurocognitive outcomes did not show significant changes within the first 1-2 years.
Purpose:
This study was conducted to investigate the neurocognitive functioning of children with intracranial germ cell tumor (IGCT) prior to receiving proton beam therapy (PBT), and to identify differential characteristics of their neurocognitive functioning depending on tumor location. As a secondary object of this study, neurocognitive functions were followed up at 1-2 years after PBT to examine early post-treatment changes.
Materials And Methods:
Between 2008 and 2014, 34 childrenwith IGCT treatedwho received PBT atNational Cancer Center, Korea were enrolled in this study. Standardized neurocognitive tests of intelligence, memory, and executive functioning were performed with baseline psychological assessments using the Child Behavior Checklist (CBCL). Follow-up assessments after PBT were conducted in 20 patients (T2). The results were analyzed based on the locations of tumors, which included the suprasellar, pineal gland, basal ganglia, and bifocal regions.
Results:
The neurocognitive function of IGCT patients was significantly lower than that of the normal population in performance intelligence quotient (p=0.041), processing speed (p=0.007), memory (p < 0.001), and executive functioning (p=0.010). Patients with basal ganglia tumors had significantly lower scores for most domains of neurocognitive functioning and higher scores for CBCL than both the normal population and patients with IGCT in other locations. There was no significant change in neurocognitive function between T1 and T2 for all types of IGCT patients in first 1-2 years after PBT.
Conclusion:
Tumor location significantly affects the neuropsychological functioning in patients with IGCT. Neuropsychological functioning should be closely monitored from the time of diagnosis in IGCT patients.
