Early Cognitive Outcomes Following Proton Radiation in Pediatric Patients With Brain and Central Nervous System Tumors
Purpose To report, from a longitudinal study, cognitive outcome in pediatric patients treated with proton radiation therapy (PRT) for central nervous system (CNS) tumors. Methods and Materials Sixty patients receiving PRT for medulloblastoma (38.3%), gliomas (18.3%), craniopharyngioma (15.0%), epend...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2015-10, Vol.93 (2), p.400-407 |
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| creator | Pulsifer, Margaret B., PhD Sethi, Roshan V., MD Kuhlthau, Karen A., PhD MacDonald, Shannon M., MD Tarbell, Nancy J., MD Yock, Torunn I., MD |
| description | Purpose To report, from a longitudinal study, cognitive outcome in pediatric patients treated with proton radiation therapy (PRT) for central nervous system (CNS) tumors. Methods and Materials Sixty patients receiving PRT for medulloblastoma (38.3%), gliomas (18.3%), craniopharyngioma (15.0%), ependymoma (11.7%), and other CNS tumors (16.7%) were administered age-appropriate measures of cognitive abilities at or near PRT initiation (baseline) and afterward (follow-up). Patients were aged ≥6 years at baseline to ensure consistency in neurocognitive measures. Results Mean age was 12.3 years at baseline; mean follow-up interval was 2.5 years. Treatment included prior surgical resection (76.7%) and chemotherapy (61.7%). Proton radiation therapy included craniospinal irradiation (46.7%) and partial brain radiation (53.3%). At baseline, mean Wechsler Full Scale IQ was 104.6; means of all 4 Index scores were also in the average range. At follow-up, no significant change was observed in mean Wechsler Full Scale IQ, Verbal Comprehension, Perceptual Reasoning/Organization, or Working Memory. However, Processing Speed scores declined significantly (mean 5.2 points), with a significantly greater decline for subjects aged |
| doi_str_mv | 10.1016/j.ijrobp.2015.06.012 |
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| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_22458788</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0360301615006331</els_id><sourcerecordid>1713942232</sourcerecordid><originalsourceid>FETCH-LOGICAL-c491t-354d1cfcced74c97ae9e38834db1facc86bf4195f591b69e93d1e60d5f59e0553</originalsourceid><addsrcrecordid>eNqFUstu1DAUtRCIDgN_gJAlNmwm-JnHBomOWkCq6IgWwc5ynJvWQ2IPtjNo_h5HKSzYsLJ9fO65j3MReklJQQkt3-4Luw--PRSMUFmQsiCUPUIrWlfNhkv5_TFaEV6SDc_kM_Qsxj0hhNJKPEVnrGRSlFWzQscLHYYT3vo7Z5M9Ar6ekvEjRHzph8H_su4O74JP3uEvurM62XyzDu9gfgRr8C5j4FLE32y6x-dB51_tOrzNYNAD_gzh6KeIb04xwYhvp9GH-Bw96fUQ4cXDuUZfLy9utx83V9cfPm3fX22MaGjKfYiOmt4Y6CphmkpDA7yuueha2mtj6rLtBW1kLxvalg00vKNQkm4GgEjJ1-j1outjsioam8DcG-8cmKQYE7KustwavVlYh-B_ThCTGm00MAzaQS5d0YryRjDGWaaKhWqCjzFArw7BjjqcFCVq9kXt1eKLmn1RpFTZlxz26iHD1I7Q_Q36Y0QmvFsIkKdxtBDmYsHlxm2Ya-28_V-GfwXMYJ01evgBJ4h7PwWXJ62oikwRdTPvxrwaVBJSck75b49GtqM</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1713942232</pqid></control><display><type>article</type><title>Early Cognitive Outcomes Following Proton Radiation in Pediatric Patients With Brain and Central Nervous System Tumors</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Pulsifer, Margaret B., PhD ; Sethi, Roshan V., MD ; Kuhlthau, Karen A., PhD ; MacDonald, Shannon M., MD ; Tarbell, Nancy J., MD ; Yock, Torunn I., MD</creator><creatorcontrib>Pulsifer, Margaret B., PhD ; Sethi, Roshan V., MD ; Kuhlthau, Karen A., PhD ; MacDonald, Shannon M., MD ; Tarbell, Nancy J., MD ; Yock, Torunn I., MD</creatorcontrib><description>Purpose To report, from a longitudinal study, cognitive outcome in pediatric patients treated with proton radiation therapy (PRT) for central nervous system (CNS) tumors. Methods and Materials Sixty patients receiving PRT for medulloblastoma (38.3%), gliomas (18.3%), craniopharyngioma (15.0%), ependymoma (11.7%), and other CNS tumors (16.7%) were administered age-appropriate measures of cognitive abilities at or near PRT initiation (baseline) and afterward (follow-up). Patients were aged ≥6 years at baseline to ensure consistency in neurocognitive measures. Results Mean age was 12.3 years at baseline; mean follow-up interval was 2.5 years. Treatment included prior surgical resection (76.7%) and chemotherapy (61.7%). Proton radiation therapy included craniospinal irradiation (46.7%) and partial brain radiation (53.3%). At baseline, mean Wechsler Full Scale IQ was 104.6; means of all 4 Index scores were also in the average range. At follow-up, no significant change was observed in mean Wechsler Full Scale IQ, Verbal Comprehension, Perceptual Reasoning/Organization, or Working Memory. However, Processing Speed scores declined significantly (mean 5.2 points), with a significantly greater decline for subjects aged <12 years at baseline and those with the highest baseline scores. Cognitive outcome was not significantly related to gender, extent of radiation, radiation dose, tumor location, histology, socioeconomic status, chemotherapy, or history of surgical resection. Conclusions Early cognitive outcomes after PRT for pediatric CNS tumors are encouraging, compared with published outcomes from photon radiation therapy.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2015.06.012</identifier><identifier>PMID: 26254679</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Analysis of Variance ; BRAIN ; Brain Neoplasms - radiotherapy ; Central Nervous System Neoplasms - radiotherapy ; CHEMOTHERAPY ; Child ; Cognition - radiation effects ; COMPARATIVE EVALUATIONS ; Comprehension - radiation effects ; Craniospinal Irradiation - adverse effects ; Craniospinal Irradiation - methods ; Female ; GLIOMAS ; Hematology, Oncology and Palliative Medicine ; HISTOLOGY ; Humans ; Intelligence - radiation effects ; Male ; Medulloblastoma - radiotherapy ; Memory, Short-Term - radiation effects ; PATIENTS ; PEDIATRICS ; Proton Therapy - adverse effects ; Proton Therapy - methods ; PROTONS ; RADIATION DOSES ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; SURGERY ; Young Adult</subject><ispartof>International journal of radiation oncology, biology, physics, 2015-10, Vol.93 (2), p.400-407</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-354d1cfcced74c97ae9e38834db1facc86bf4195f591b69e93d1e60d5f59e0553</citedby><cites>FETCH-LOGICAL-c491t-354d1cfcced74c97ae9e38834db1facc86bf4195f591b69e93d1e60d5f59e0553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0360301615006331$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26254679$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22458788$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Pulsifer, Margaret B., PhD</creatorcontrib><creatorcontrib>Sethi, Roshan V., MD</creatorcontrib><creatorcontrib>Kuhlthau, Karen A., PhD</creatorcontrib><creatorcontrib>MacDonald, Shannon M., MD</creatorcontrib><creatorcontrib>Tarbell, Nancy J., MD</creatorcontrib><creatorcontrib>Yock, Torunn I., MD</creatorcontrib><title>Early Cognitive Outcomes Following Proton Radiation in Pediatric Patients With Brain and Central Nervous System Tumors</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose To report, from a longitudinal study, cognitive outcome in pediatric patients treated with proton radiation therapy (PRT) for central nervous system (CNS) tumors. Methods and Materials Sixty patients receiving PRT for medulloblastoma (38.3%), gliomas (18.3%), craniopharyngioma (15.0%), ependymoma (11.7%), and other CNS tumors (16.7%) were administered age-appropriate measures of cognitive abilities at or near PRT initiation (baseline) and afterward (follow-up). Patients were aged ≥6 years at baseline to ensure consistency in neurocognitive measures. Results Mean age was 12.3 years at baseline; mean follow-up interval was 2.5 years. Treatment included prior surgical resection (76.7%) and chemotherapy (61.7%). Proton radiation therapy included craniospinal irradiation (46.7%) and partial brain radiation (53.3%). At baseline, mean Wechsler Full Scale IQ was 104.6; means of all 4 Index scores were also in the average range. At follow-up, no significant change was observed in mean Wechsler Full Scale IQ, Verbal Comprehension, Perceptual Reasoning/Organization, or Working Memory. However, Processing Speed scores declined significantly (mean 5.2 points), with a significantly greater decline for subjects aged <12 years at baseline and those with the highest baseline scores. Cognitive outcome was not significantly related to gender, extent of radiation, radiation dose, tumor location, histology, socioeconomic status, chemotherapy, or history of surgical resection. Conclusions Early cognitive outcomes after PRT for pediatric CNS tumors are encouraging, compared with published outcomes from photon radiation therapy.</description><subject>Adolescent</subject><subject>Analysis of Variance</subject><subject>BRAIN</subject><subject>Brain Neoplasms - radiotherapy</subject><subject>Central Nervous System Neoplasms - radiotherapy</subject><subject>CHEMOTHERAPY</subject><subject>Child</subject><subject>Cognition - radiation effects</subject><subject>COMPARATIVE EVALUATIONS</subject><subject>Comprehension - radiation effects</subject><subject>Craniospinal Irradiation - adverse effects</subject><subject>Craniospinal Irradiation - methods</subject><subject>Female</subject><subject>GLIOMAS</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>HISTOLOGY</subject><subject>Humans</subject><subject>Intelligence - radiation effects</subject><subject>Male</subject><subject>Medulloblastoma - radiotherapy</subject><subject>Memory, Short-Term - radiation effects</subject><subject>PATIENTS</subject><subject>PEDIATRICS</subject><subject>Proton Therapy - adverse effects</subject><subject>Proton Therapy - methods</subject><subject>PROTONS</subject><subject>RADIATION DOSES</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>SURGERY</subject><subject>Young Adult</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUstu1DAUtRCIDgN_gJAlNmwm-JnHBomOWkCq6IgWwc5ynJvWQ2IPtjNo_h5HKSzYsLJ9fO65j3MReklJQQkt3-4Luw--PRSMUFmQsiCUPUIrWlfNhkv5_TFaEV6SDc_kM_Qsxj0hhNJKPEVnrGRSlFWzQscLHYYT3vo7Z5M9Ar6ekvEjRHzph8H_su4O74JP3uEvurM62XyzDu9gfgRr8C5j4FLE32y6x-dB51_tOrzNYNAD_gzh6KeIb04xwYhvp9GH-Bw96fUQ4cXDuUZfLy9utx83V9cfPm3fX22MaGjKfYiOmt4Y6CphmkpDA7yuueha2mtj6rLtBW1kLxvalg00vKNQkm4GgEjJ1-j1outjsioam8DcG-8cmKQYE7KustwavVlYh-B_ThCTGm00MAzaQS5d0YryRjDGWaaKhWqCjzFArw7BjjqcFCVq9kXt1eKLmn1RpFTZlxz26iHD1I7Q_Q36Y0QmvFsIkKdxtBDmYsHlxm2Ya-28_V-GfwXMYJ01evgBJ4h7PwWXJ62oikwRdTPvxrwaVBJSck75b49GtqM</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Pulsifer, Margaret B., PhD</creator><creator>Sethi, Roshan V., MD</creator><creator>Kuhlthau, Karen A., PhD</creator><creator>MacDonald, Shannon M., MD</creator><creator>Tarbell, Nancy J., MD</creator><creator>Yock, Torunn I., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20151001</creationdate><title>Early Cognitive Outcomes Following Proton Radiation in Pediatric Patients With Brain and Central Nervous System Tumors</title><author>Pulsifer, Margaret B., PhD ; Sethi, Roshan V., MD ; Kuhlthau, Karen A., PhD ; MacDonald, Shannon M., MD ; Tarbell, Nancy J., MD ; Yock, Torunn I., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-354d1cfcced74c97ae9e38834db1facc86bf4195f591b69e93d1e60d5f59e0553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Analysis of Variance</topic><topic>BRAIN</topic><topic>Brain Neoplasms - radiotherapy</topic><topic>Central Nervous System Neoplasms - radiotherapy</topic><topic>CHEMOTHERAPY</topic><topic>Child</topic><topic>Cognition - radiation effects</topic><topic>COMPARATIVE EVALUATIONS</topic><topic>Comprehension - radiation effects</topic><topic>Craniospinal Irradiation - adverse effects</topic><topic>Craniospinal Irradiation - methods</topic><topic>Female</topic><topic>GLIOMAS</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>HISTOLOGY</topic><topic>Humans</topic><topic>Intelligence - radiation effects</topic><topic>Male</topic><topic>Medulloblastoma - radiotherapy</topic><topic>Memory, Short-Term - radiation effects</topic><topic>PATIENTS</topic><topic>PEDIATRICS</topic><topic>Proton Therapy - adverse effects</topic><topic>Proton Therapy - methods</topic><topic>PROTONS</topic><topic>RADIATION DOSES</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>SURGERY</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pulsifer, Margaret B., PhD</creatorcontrib><creatorcontrib>Sethi, Roshan V., MD</creatorcontrib><creatorcontrib>Kuhlthau, Karen A., PhD</creatorcontrib><creatorcontrib>MacDonald, Shannon M., MD</creatorcontrib><creatorcontrib>Tarbell, Nancy J., MD</creatorcontrib><creatorcontrib>Yock, Torunn I., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pulsifer, Margaret B., PhD</au><au>Sethi, Roshan V., MD</au><au>Kuhlthau, Karen A., PhD</au><au>MacDonald, Shannon M., MD</au><au>Tarbell, Nancy J., MD</au><au>Yock, Torunn I., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early Cognitive Outcomes Following Proton Radiation in Pediatric Patients With Brain and Central Nervous System Tumors</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>93</volume><issue>2</issue><spage>400</spage><epage>407</epage><pages>400-407</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>Purpose To report, from a longitudinal study, cognitive outcome in pediatric patients treated with proton radiation therapy (PRT) for central nervous system (CNS) tumors. Methods and Materials Sixty patients receiving PRT for medulloblastoma (38.3%), gliomas (18.3%), craniopharyngioma (15.0%), ependymoma (11.7%), and other CNS tumors (16.7%) were administered age-appropriate measures of cognitive abilities at or near PRT initiation (baseline) and afterward (follow-up). Patients were aged ≥6 years at baseline to ensure consistency in neurocognitive measures. Results Mean age was 12.3 years at baseline; mean follow-up interval was 2.5 years. Treatment included prior surgical resection (76.7%) and chemotherapy (61.7%). Proton radiation therapy included craniospinal irradiation (46.7%) and partial brain radiation (53.3%). At baseline, mean Wechsler Full Scale IQ was 104.6; means of all 4 Index scores were also in the average range. At follow-up, no significant change was observed in mean Wechsler Full Scale IQ, Verbal Comprehension, Perceptual Reasoning/Organization, or Working Memory. However, Processing Speed scores declined significantly (mean 5.2 points), with a significantly greater decline for subjects aged <12 years at baseline and those with the highest baseline scores. Cognitive outcome was not significantly related to gender, extent of radiation, radiation dose, tumor location, histology, socioeconomic status, chemotherapy, or history of surgical resection. Conclusions Early cognitive outcomes after PRT for pediatric CNS tumors are encouraging, compared with published outcomes from photon radiation therapy.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26254679</pmid><doi>10.1016/j.ijrobp.2015.06.012</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Analysis of Variance BRAIN Brain Neoplasms - radiotherapy Central Nervous System Neoplasms - radiotherapy CHEMOTHERAPY Child Cognition - radiation effects COMPARATIVE EVALUATIONS Comprehension - radiation effects Craniospinal Irradiation - adverse effects Craniospinal Irradiation - methods Female GLIOMAS Hematology, Oncology and Palliative Medicine HISTOLOGY Humans Intelligence - radiation effects Male Medulloblastoma - radiotherapy Memory, Short-Term - radiation effects PATIENTS PEDIATRICS Proton Therapy - adverse effects Proton Therapy - methods PROTONS RADIATION DOSES Radiology RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY SURGERY Young Adult |
| title | Early Cognitive Outcomes Following Proton Radiation in Pediatric Patients With Brain and Central Nervous System Tumors |
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