Impact of surgery and adjuvant therapy on balance function in children and adolescents with cerebellar tumors

Neuropediatrics. 2006 Dec;37(6):350-8. doi: 10.1055/s-2007-964904.


Objectives: This study examined the effects of posterior fossa tumor surgery and concomitant irradiation and/or chemotherapy on the long-term recovery of balance function in children and adolescent patients.

Subjects and methods: 22 patients, treated during childhood for a benign (n = 14) or malignant cerebellar tumor (n = 8), were examined in chronic state (mean latency between surgery and testing: 7.7 years, range 3 - 17 years). Postural impairments were assessed with static and dynamic posturography. All cerebellar lesions were documented by standardized and normalized MRI data. Healthy age- and gender-matched subjects served as a control group.

Results: Comparing the balance function of (i) children with or without affected cerebellar nuclei and (ii) children with and without adjuvant chemotherapy and/or radiotherapy revealed that damage to the cerebellar nuclei had more impact on neurological impairment than concomitant tumor therapy. Balance abnormalities were most pronounced when a lesion affected the fastigial nucleus. Chemotherapy with its neurological side effect was associated with enhanced postural sway in only two children with malignant tumors.

Conclusions: The study results indicate that the sparing of the deep cerebellar nuclei had the greatest impact on the recovery of balance function in pediatric patients treated for both a benign or malignant cerebellar tumor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cerebellar Neoplasms / drug therapy
  • Cerebellar Neoplasms / pathology
  • Cerebellar Neoplasms / radiotherapy
  • Cerebellar Neoplasms / surgery*
  • Cerebellar Nuclei / drug effects
  • Cerebellar Nuclei / pathology
  • Cerebellar Nuclei / radiation effects
  • Cerebellar Nuclei / surgery
  • Cerebellum / drug effects
  • Cerebellum / radiation effects
  • Cerebellum / surgery
  • Chemotherapy, Adjuvant
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Cranial Irradiation
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • Neurologic Examination / drug effects
  • Postoperative Complications / diagnosis
  • Postoperative Complications / pathology
  • Postural Balance* / drug effects
  • Postural Balance* / radiation effects
  • Radiotherapy, Adjuvant