Author/Editor		Macedoni-Lukšič, Marta
Title		Kasne nevrološke posledice pri otrocih, zdravljenih zaradi možganskega tumorja
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		1999
Volume		str. 121
Language		slo
Abstract		Survival of children treated for brain tumors has improved during the last 25 years and, in long-term survivors, late sequelae have become a major concern. We evaluated 61 long-term survivors to determine neurological impairment, disability and handicap after treatment. Patients and methods: From 248 children registered at the Cancer Regioster of Slovenia, treated for brain tumor between 1969 and 1992, 99 are still alive and 4 are lost from the follow up. Of 99 patients (pts) 88 were at least 15 years old and have been observed for at least 3 years after treatment. Nineteen patients refused to be evaluated, 2 are living outside Slovenia and we didn't find medical documentation for 6 pts. The final sample therefore consisted of 61 pts (20 females, 41 males, aged 1-16 years at diagnosis). They were evaluated at the age of 15-42, 5-28 years after treatment. Nine pts had only surgery, 3 had only radiotherapy (RT), 4RT and chemotherapy (CHT), 15 surgery, RT and CHT and 30 pts had surgery with RT. All 61 pts were interviewed regarding their social life, schooling and employment for evaluation of their handicap. Neurological examination included computed tomography (CT) or magnetic resonance imaging (MRI) of the brain (all pts) and ophthalmologic examination (47 pts). Psychological evaluation (54 pts) included Wechsler Bellevue Intelligence test. Disability was classified into 4 categories (none-severe) regarding pts ability of self care. The data were analysed using decision-trees method. Results: Thirty-eight pts (70%) had at least one impairment. Visual impairment was detected in 14 pts (24%) and is associated with recurrence (p=0.012). Thirty-gour pts (56%) had motor impairment; in the group of the irradiated pts sex (female) is the most important risk factor. Thirteen pts (21%) had epilepsy. It is associated with supratentorial location of tumor (p=0.001). CT scan showed generalised brain atrophy in 13 pts (21%); ( Abstract truncated at 2000 characters.)
Descriptors		BRAIN NEOPLASMS RADIOTHERAPY ANTINEOPLASTIC AGENTS CHILD TOMOGRAPHY, X-RAY COMPUTED MAGNETIC RESONANCE IMAGING PSYCHOLOGICAL TESTS VISION DISORDERS HYDROCEPHALUS EPILEPSY COGNITION DISORDERS MOTOR NEURON DISEASE QUESTIONNAIRES