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@ARTICLE{Mynarek:272896,
      author       = {Mynarek, Martin and Rossius, Anne and Guiard, Anika and
                      Ottensmeier, Holger and von Hoff, Katja and Obrecht-Sturm,
                      Denise and Bußenius, Lisa and Friedrich, Carsten and von
                      Bueren, Andre O and Gerber, Nicolas U and Traunwieser,
                      Thomas and Kortmann, Rolf-Dieter and Warmuth-Metz, Monika
                      and Bison, Brigitte and Thomale, Ulrich-W and Krauss,
                      Juergen and Pietsch, Torsten and Clifford, Steven C and
                      Pfister, Stefan M and Sturm, Dominik and Sahm, Felix and
                      Tischler, Tanja and Rutkowski, Stefan},
      title        = {{R}isk factors for domain-specific neurocognitive outcome
                      in pediatric survivors of a brain tumor in the posterior
                      fossa-{R}esults of the {HIT} 2000 trial.},
      journal      = {Neuro-Oncology},
      volume       = {26},
      number       = {11},
      issn         = {1522-8517},
      address      = {Oxford},
      publisher    = {Oxford Univ. Press},
      reportid     = {DZNE-2024-01308},
      pages        = {2113 - 2124},
      year         = {2024},
      abstract     = {Neurocognition can be severely affected in pediatric brain
                      tumor survivors. We analyzed the association of cognitive
                      functioning with radiotherapy dose, postoperative cerebellar
                      mutism syndrome (pCMS), hydrocephalus, intraventricular
                      methotrexate (MTX) application, tumor localization, and
                      biology in pediatric survivors of a posterior fossa
                      tumor.Subdomain-specific neurocognitive outcome data from
                      279 relapse-free survivors of the HIT-2000 trial (241
                      medulloblastoma and 38 infratentorial ependymoma) using the
                      Neuropsychological Basic Diagnostic tool based on
                      Cattell-Horn-Carroll's model for intelligence were
                      analyzed.Cognitive performance 5.14 years (mean; range =
                      1.52-13.02) after diagnosis was significantly below normal
                      for all subtests. Processing speed and psychomotor abilities
                      were most affected. Influencing factors were
                      domain-specific: CSI-dose had a strong impact on most
                      subtests. pCMS was associated with psychomotor abilities (β
                      = -0.25 to -0.16) and processing speed (β = -0.32).
                      Postoperative hydrocephalus correlated with crystallized
                      intelligence (β = -0.20) and short-term memory (β =
                      -0.15), age with crystallized intelligence (β = 0.15) and
                      psychomotor abilities (β = -0.16 and β = -0.17). Scores
                      for fluid intelligence (β = -0.23), short-term memory (β =
                      -0.17) and visual processing (β = -0.25) declined, and
                      scores for selective attention improved (β = 0.29) with
                      time after diagnosis.The dose of CSI was strongly associated
                      with neurocognitive outcomes. Low psychomotor abilities and
                      processing speed both in patients treated with and without
                      CSI suggest a strong contribution of the tumor and its
                      surgery on these functions. Future research therefore should
                      analyze strategies to both reduce CSI dose and toxicity
                      caused by other treatment modalities.},
      keywords     = {Humans / Child / Female / Male / Infratentorial Neoplasms:
                      therapy / Adolescent / Child, Preschool / Medulloblastoma:
                      therapy / Risk Factors / Ependymoma: therapy /
                      Neuropsychological Tests / Cancer Survivors: psychology /
                      Cancer Survivors: statistics $\&$ numerical data / Follow-Up
                      Studies / Hydrocephalus: etiology / Cognition Disorders:
                      etiology / Prognosis / Mutism: etiology / ependymoma (Other)
                      / infant (Other) / medulloblastoma (Other) /
                      neuropsychological late effects (Other) / quality of
                      survival (Other)},
      cin          = {Brainbank (Bonn)},
      ddc          = {610},
      cid          = {I:(DE-2719)1011009},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:38835160},
      pmc          = {pmc:PMC11534318},
      doi          = {10.1093/neuonc/noae092},
      url          = {https://pub.dzne.de/record/272896},
}