BACKGROUND: Radiotherapy (RT) in the pediatric brain tumor population causes late neurocognitive effects. In the current study, the authors investigated associations between clinical and dosimetric risk factors and memory outcomes in a cohort of patients treated with proton radiotherapy (PRT). METHODS: A total of 70 patients (median age at PRT, 12.1 years [range, 5.0-22.5 years]) who were treated with PRT were identified with baseline and follow-up evaluations of visual and verbal memory (Children's Memory Scale and the third edition of the Wechsler Memory Scale). Whole-brain as well as bilateral hippocampal and temporal lobe contours were delineated for the calculation of dosimetric indices. Multivariate analyses were performed to assess associations of score changes over time with clinical factors and dosimetric indices. RESULTS: The median neurocognitive follow-up was 3.0 years (range, 1.1-11.4 years). For the entire cohort, delayed and immediate verbal memory scaled scores demonstrated small declines. The mean decline for delayed verbal memory scores was 0.6 (P = .01), and that for immediate verbal memory scores was 0.5 (P = .06). Immediate and delayed visual memory scores were not found to change significantly (+0.1 and -0.3, respectively; P>.30). A higher left hippocampal V20GyE (percentage of the volume of a particular anatomical region receiving at least a 20 gray equivalent) was correlated with a score decline in all 4 measures. Female sex was found to be predictive of lower delayed verbal memory follow-up scores (P = .035). CONCLUSIONS: Only delayed verbal memory scores were found to have declined statistically significantly at follow-up after PRT, reflecting some weakness in verbal memory retrieval. Given a correlation of left hippocampal dosimetry and memory outcomes after PRT, left hippocampal-sparing PRT plans may assist patients with pediatric brain tumors in preserving memory-retrieval abilities. Cancer 2018;124:2238-45.
BACKGROUND: Radiotherapy (RT) in the pediatric brain tumor population causes late neurocognitive effects. In the current study, the authors investigated associations between clinical and dosimetric risk factors and memory outcomes in a cohort of patients treated with proton radiotherapy (PRT). METHODS: A total of 70 patients (median age at PRT, 12.1 years [range, 5.0-22.5 years]) who were treated with PRT were identified with baseline and follow-up evaluations of visual and verbal memory (Children's Memory Scale and the third edition of the Wechsler Memory Scale). Whole-brain as well as bilateral hippocampal and temporal lobe contours were delineated for the calculation of dosimetric indices. Multivariate analyses were performed to assess associations of score changes over time with clinical factors and dosimetric indices. RESULTS: The median neurocognitive follow-up was 3.0 years (range, 1.1-11.4 years). For the entire cohort, delayed and immediate verbal memory scaled scores demonstrated small declines. The mean decline for delayed verbal memory scores was 0.6 (P = .01), and that for immediate verbal memory scores was 0.5 (P = .06). Immediate and delayed visual memory scores were not found to change significantly (+0.1 and -0.3, respectively; P>.30). A higher left hippocampal V20GyE (percentage of the volume of a particular anatomical region receiving at least a 20 gray equivalent) was correlated with a score decline in all 4 measures. Female sex was found to be predictive of lower delayed verbal memory follow-up scores (P = .035). CONCLUSIONS: Only delayed verbal memory scores were found to have declined statistically significantly at follow-up after PRT, reflecting some weakness in verbal memory retrieval. Given a correlation of left hippocampal dosimetry and memory outcomes after PRT, left hippocampal-sparing PRT plans may assist patients with pediatric brain tumors in preserving memory-retrieval abilities. Cancer 2018;124:2238-45.
Authors: Kimberly P Raghubar; Michael Lamba; Kim M Cecil; Keith Owen Yeates; E Mark Mahone; Christina Limke; David Grosshans; Travis J Beckwith; M Douglas Ris Journal: Pediatr Blood Cancer Date: 2018-06-01 Impact factor: 3.167
Authors: Yolanda D Tseng; William Hartsell; Henry Tsai; Shahed Badiyan; Chiachien J Wang; Carl Rossi; Rupesh Kotecha; Sujay Vora; Carlos Vargas; Gary Larson; Lia M Halasz Journal: Neuro Oncol Date: 2018-10-09 Impact factor: 12.300
Authors: Alexandra K Roth; M Douglas Ris; Jessica Orobio; Judy Xue; Anita Mahajan; Arnold C Paulino; David Grosshans; M Fatih Okcu; Murali Chintagumpala; Lisa S Kahalley Journal: Pediatr Blood Cancer Date: 2019-11-17 Impact factor: 3.167
Authors: Derek S Tsang; Laurence Kim; Zhihui Amy Liu; Laura Janzen; Mohammad Khandwala; Eric Bouffet; Normand Laperriere; Hitesh Dama; Dana Keilty; Tim Craig; Vijay Ramaswamy; David C Hodgson; Donald Mabbott Journal: Neuro Oncol Date: 2021-03-25 Impact factor: 12.300
Authors: Christian Bäumer; Sandija Plaude; Dalia Ahmad Khalil; Dirk Geismar; Paul-Heinz Kramer; Kevin Kröninger; Christian Nitsch; Jörg Wulff; Beate Timmermann Journal: Front Oncol Date: 2021-05-12 Impact factor: 6.244