PURPOSE: To analyze the relationship between craniospinal irradiation (CSI) and intellectual outcome in children with posterior fossa (PF) tumors. METHODS AND MATERIALS: A neuropsychological evaluation was performed retrospectively in 31 children, aged 5-15 years, who had received radiotherapy for PF tumors, and who had been off therapy for at least 1 year. Factors evaluated for impact on intellectual outcome were: socioeconomic status, disease presentation, histology, complications, chemotherapy, age at radiotherapy, interval between radiotherapy and testing, and radiation doses and volumes. Patients were divided into 3 subgroups according to the CSI doses (0 Gy [i.e., PF irradiation only], 25 Gy, and 35 Gy), with 11, 11, and 9 patients, respectively. RESULTS: Long-term cognitive impairment occurred in most of the patients, even after PF irradiation only. Moreover, there was a significant correlation between the full-scale IQ score (FSIQ) and the CSI dose, with mean FSIQ scores at 84.5 (SD = 14.0), 76.9 (SD = 16.6), and 63.7 (SD = 15.4) for 0 Gy, 25 Gy, and 35 Gy of CS1, respectively. A marked drop in verbal comprehension scores was noted in children who had received the higher dose. CONCLUSION: This preliminary study further supports the rationale for de-escalation of CSI doses and volumes in standard-risk PF tumors.
PURPOSE: To analyze the relationship between craniospinal irradiation (CSI) and intellectual outcome in children with posterior fossa (PF) tumors. METHODS AND MATERIALS: A neuropsychological evaluation was performed retrospectively in 31 children, aged 5-15 years, who had received radiotherapy for PF tumors, and who had been off therapy for at least 1 year. Factors evaluated for impact on intellectual outcome were: socioeconomic status, disease presentation, histology, complications, chemotherapy, age at radiotherapy, interval between radiotherapy and testing, and radiation doses and volumes. Patients were divided into 3 subgroups according to the CSI doses (0 Gy [i.e., PF irradiation only], 25 Gy, and 35 Gy), with 11, 11, and 9 patients, respectively. RESULTS: Long-term cognitive impairment occurred in most of the patients, even after PF irradiation only. Moreover, there was a significant correlation between the full-scale IQ score (FSIQ) and the CSI dose, with mean FSIQ scores at 84.5 (SD = 14.0), 76.9 (SD = 16.6), and 63.7 (SD = 15.4) for 0 Gy, 25 Gy, and 35 Gy of CS1, respectively. A marked drop in verbal comprehension scores was noted in children who had received the higher dose. CONCLUSION: This preliminary study further supports the rationale for de-escalation of CSI doses and volumes in standard-risk PF tumors.
Authors: Malin Blomstrand; N Patrik Brodin; Per Munck Af Rosenschöld; Ivan R Vogelius; Gaspar Sánchez Merino; Anne Kiil-Berthlesen; Klas Blomgren; Birgitta Lannering; Søren M Bentzen; Thomas Björk-Eriksson Journal: Neuro Oncol Date: 2012-05-17 Impact factor: 12.300
Authors: N Patrik Brodin; Per Munck af Rosenschöld; Malin Blomstrand; Anne Kiil-Berthlesen; Christian Hollensen; Ivan R Vogelius; Birgitta Lannering; Søren M Bentzen; Thomas Björk-Eriksson Journal: Neuro Oncol Date: 2013-12-09 Impact factor: 12.300
Authors: Tara M Brinkman; Wilburn E Reddick; Joshua Luxton; John O Glass; Noah D Sabin; Deo Kumar Srivastava; Leslie L Robison; Melissa M Hudson; Kevin R Krull Journal: Neuro Oncol Date: 2012-09 Impact factor: 12.300
Authors: Heather M Conklin; Jason M Ashford; Marcos Di Pinto; Christopher G Vaughan; Gerard A Gioia; Thomas E Merchant; Robert J Ogg; Victor Santana; Shengjie Wu Journal: J Neurooncol Date: 2013-03-25 Impact factor: 4.130