Left hippocampal dosimetry correlates with visual and verbal memory outcomes in survivors of pediatric brain tumors
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). METHOD...
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| Veröffentlicht in: | Cancer 2018-05, Vol.124 (10), p.2238-2245 |
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| creator | Zureick, Andrew H. Evans, Casey L. Niemierko, Andrzej Grieco, Julie A. Nichols, Alexandra J. Fullerton, Barbara C. Hess, Clayton B. Goebel, Claire P. Gallotto, Sara L. Weyman, Elizabeth A. Gaudet, Dillon E. Nartowicz, Jessica A. Ebb, David H. Jones, Robin M. MacDonald, Shannon M. Tarbell, Nancy J. Yock, Torunn I. Pulsifer, Margaret B. |
| description | 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. © 2018 American Cancer Society.
In this pediatric brain tumor cohort, visual and verbal memory skills after proton radiotherapy are found to be largely stable. However, increased dose to the left hippocampus appears to be predictive of lower follow‐up memory scores. |
| doi_str_mv | 10.1002/cncr.31143 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2010372219</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2034358141</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3933-6befbf047bfbd05ca12dd142b33001171f97a08a99d845be65344df0dcb23ce53</originalsourceid><addsrcrecordid>eNp90U1LHTEUBuBQWvRq3fQHlEA3IoyefIwzWcrFVuHSQrHQ3ZCPE4zMTMZk5sr994291oWLrpKQh5ecvIR8YnDOAPiFHW06F4xJ8Y6sGKimAib5e7ICgLaqpfh9SI5yfijHhtfigBxyJZWCtl6RvEE_0_swTdHqYdI9dTGHAee0ozamhL2eMdOnMN_TbchLAXp0dIvJlO2AQywwLrONQ2FhpHlJ27CNKdPo6YQu6DkFS03S5XJeis8fyQev-4wnL-sx-fX1-m59U21-fLtdX20qK5QQ1aVBbzzIxnjjoLaacefKYEYIAMYa5lWjodVKuVbWBi9rIaXz4KzhwmItjsnpPndK8XHBPHdDyBb7Xo8Yl9xxYCAazpkq9Msb-hCXNJbXFSWkqFsmWVFne2VTzDmh76YUBp12HYPuuYruuYrubxUFf36JXMyA7pX--_sC2B48hR53_4nq1t_XP_ehfwAm3pXP</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2034358141</pqid></control><display><type>article</type><title>Left hippocampal dosimetry correlates with visual and verbal memory outcomes in survivors of pediatric brain tumors</title><source>Wiley Free Content</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Zureick, Andrew H. ; Evans, Casey L. ; Niemierko, Andrzej ; Grieco, Julie A. ; Nichols, Alexandra J. ; Fullerton, Barbara C. ; Hess, Clayton B. ; Goebel, Claire P. ; Gallotto, Sara L. ; Weyman, Elizabeth A. ; Gaudet, Dillon E. ; Nartowicz, Jessica A. ; Ebb, David H. ; Jones, Robin M. ; MacDonald, Shannon M. ; Tarbell, Nancy J. ; Yock, Torunn I. ; Pulsifer, Margaret B.</creator><creatorcontrib>Zureick, Andrew H. ; Evans, Casey L. ; Niemierko, Andrzej ; Grieco, Julie A. ; Nichols, Alexandra J. ; Fullerton, Barbara C. ; Hess, Clayton B. ; Goebel, Claire P. ; Gallotto, Sara L. ; Weyman, Elizabeth A. ; Gaudet, Dillon E. ; Nartowicz, Jessica A. ; Ebb, David H. ; Jones, Robin M. ; MacDonald, Shannon M. ; Tarbell, Nancy J. ; Yock, Torunn I. ; Pulsifer, Margaret B.</creatorcontrib><description>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. © 2018 American Cancer Society.
In this pediatric brain tumor cohort, visual and verbal memory skills after proton radiotherapy are found to be largely stable. However, increased dose to the left hippocampus appears to be predictive of lower follow‐up memory scores.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.31143</identifier><identifier>PMID: 29499085</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Brain ; Brain cancer ; Brain tumors ; Cancer ; central nervous system (CNS) neoplasms ; child ; Children ; Cognition ; Correlation analysis ; Dosimeters ; Dosimetry ; Hippocampus ; learning ; long‐term memory ; Memory ; Oncology ; Patients ; Pediatrics ; proton therapy ; Radiation therapy ; Retrieval ; Risk analysis ; Risk factors ; short‐term memory ; survivors ; Temporal lobe ; Tumors ; verbal learning</subject><ispartof>Cancer, 2018-05, Vol.124 (10), p.2238-2245</ispartof><rights>2018 American Cancer Society</rights><rights>2018 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3933-6befbf047bfbd05ca12dd142b33001171f97a08a99d845be65344df0dcb23ce53</citedby><cites>FETCH-LOGICAL-c3933-6befbf047bfbd05ca12dd142b33001171f97a08a99d845be65344df0dcb23ce53</cites><orcidid>0000-0002-6030-4343</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.31143$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.31143$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29499085$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zureick, Andrew H.</creatorcontrib><creatorcontrib>Evans, Casey L.</creatorcontrib><creatorcontrib>Niemierko, Andrzej</creatorcontrib><creatorcontrib>Grieco, Julie A.</creatorcontrib><creatorcontrib>Nichols, Alexandra J.</creatorcontrib><creatorcontrib>Fullerton, Barbara C.</creatorcontrib><creatorcontrib>Hess, Clayton B.</creatorcontrib><creatorcontrib>Goebel, Claire P.</creatorcontrib><creatorcontrib>Gallotto, Sara L.</creatorcontrib><creatorcontrib>Weyman, Elizabeth A.</creatorcontrib><creatorcontrib>Gaudet, Dillon E.</creatorcontrib><creatorcontrib>Nartowicz, Jessica A.</creatorcontrib><creatorcontrib>Ebb, David H.</creatorcontrib><creatorcontrib>Jones, Robin M.</creatorcontrib><creatorcontrib>MacDonald, Shannon M.</creatorcontrib><creatorcontrib>Tarbell, Nancy J.</creatorcontrib><creatorcontrib>Yock, Torunn I.</creatorcontrib><creatorcontrib>Pulsifer, Margaret B.</creatorcontrib><title>Left hippocampal dosimetry correlates with visual and verbal memory outcomes in survivors of pediatric brain tumors</title><title>Cancer</title><addtitle>Cancer</addtitle><description>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. © 2018 American Cancer Society.
In this pediatric brain tumor cohort, visual and verbal memory skills after proton radiotherapy are found to be largely stable. However, increased dose to the left hippocampus appears to be predictive of lower follow‐up memory scores.</description><subject>Brain</subject><subject>Brain cancer</subject><subject>Brain tumors</subject><subject>Cancer</subject><subject>central nervous system (CNS) neoplasms</subject><subject>child</subject><subject>Children</subject><subject>Cognition</subject><subject>Correlation analysis</subject><subject>Dosimeters</subject><subject>Dosimetry</subject><subject>Hippocampus</subject><subject>learning</subject><subject>long‐term memory</subject><subject>Memory</subject><subject>Oncology</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>proton therapy</subject><subject>Radiation therapy</subject><subject>Retrieval</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>short‐term memory</subject><subject>survivors</subject><subject>Temporal lobe</subject><subject>Tumors</subject><subject>verbal learning</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp90U1LHTEUBuBQWvRq3fQHlEA3IoyefIwzWcrFVuHSQrHQ3ZCPE4zMTMZk5sr994291oWLrpKQh5ecvIR8YnDOAPiFHW06F4xJ8Y6sGKimAib5e7ICgLaqpfh9SI5yfijHhtfigBxyJZWCtl6RvEE_0_swTdHqYdI9dTGHAee0ozamhL2eMdOnMN_TbchLAXp0dIvJlO2AQywwLrONQ2FhpHlJ27CNKdPo6YQu6DkFS03S5XJeis8fyQev-4wnL-sx-fX1-m59U21-fLtdX20qK5QQ1aVBbzzIxnjjoLaacefKYEYIAMYa5lWjodVKuVbWBi9rIaXz4KzhwmItjsnpPndK8XHBPHdDyBb7Xo8Yl9xxYCAazpkq9Msb-hCXNJbXFSWkqFsmWVFne2VTzDmh76YUBp12HYPuuYruuYrubxUFf36JXMyA7pX--_sC2B48hR53_4nq1t_XP_ehfwAm3pXP</recordid><startdate>20180515</startdate><enddate>20180515</enddate><creator>Zureick, Andrew H.</creator><creator>Evans, Casey L.</creator><creator>Niemierko, Andrzej</creator><creator>Grieco, Julie A.</creator><creator>Nichols, Alexandra J.</creator><creator>Fullerton, Barbara C.</creator><creator>Hess, Clayton B.</creator><creator>Goebel, Claire P.</creator><creator>Gallotto, Sara L.</creator><creator>Weyman, Elizabeth A.</creator><creator>Gaudet, Dillon E.</creator><creator>Nartowicz, Jessica A.</creator><creator>Ebb, David H.</creator><creator>Jones, Robin M.</creator><creator>MacDonald, Shannon M.</creator><creator>Tarbell, Nancy J.</creator><creator>Yock, Torunn I.</creator><creator>Pulsifer, Margaret B.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6030-4343</orcidid></search><sort><creationdate>20180515</creationdate><title>Left hippocampal dosimetry correlates with visual and verbal memory outcomes in survivors of pediatric brain tumors</title><author>Zureick, Andrew H. ; Evans, Casey L. ; Niemierko, Andrzej ; Grieco, Julie A. ; Nichols, Alexandra J. ; Fullerton, Barbara C. ; Hess, Clayton B. ; Goebel, Claire P. ; Gallotto, Sara L. ; Weyman, Elizabeth A. ; Gaudet, Dillon E. ; Nartowicz, Jessica A. ; Ebb, David H. ; Jones, Robin M. ; MacDonald, Shannon M. ; Tarbell, Nancy J. ; Yock, Torunn I. ; Pulsifer, Margaret B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3933-6befbf047bfbd05ca12dd142b33001171f97a08a99d845be65344df0dcb23ce53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Brain</topic><topic>Brain cancer</topic><topic>Brain tumors</topic><topic>Cancer</topic><topic>central nervous system (CNS) neoplasms</topic><topic>child</topic><topic>Children</topic><topic>Cognition</topic><topic>Correlation analysis</topic><topic>Dosimeters</topic><topic>Dosimetry</topic><topic>Hippocampus</topic><topic>learning</topic><topic>long‐term memory</topic><topic>Memory</topic><topic>Oncology</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>proton therapy</topic><topic>Radiation therapy</topic><topic>Retrieval</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>short‐term memory</topic><topic>survivors</topic><topic>Temporal lobe</topic><topic>Tumors</topic><topic>verbal learning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zureick, Andrew H.</creatorcontrib><creatorcontrib>Evans, Casey L.</creatorcontrib><creatorcontrib>Niemierko, Andrzej</creatorcontrib><creatorcontrib>Grieco, Julie A.</creatorcontrib><creatorcontrib>Nichols, Alexandra J.</creatorcontrib><creatorcontrib>Fullerton, Barbara C.</creatorcontrib><creatorcontrib>Hess, Clayton B.</creatorcontrib><creatorcontrib>Goebel, Claire P.</creatorcontrib><creatorcontrib>Gallotto, Sara L.</creatorcontrib><creatorcontrib>Weyman, Elizabeth A.</creatorcontrib><creatorcontrib>Gaudet, Dillon E.</creatorcontrib><creatorcontrib>Nartowicz, Jessica A.</creatorcontrib><creatorcontrib>Ebb, David H.</creatorcontrib><creatorcontrib>Jones, Robin M.</creatorcontrib><creatorcontrib>MacDonald, Shannon M.</creatorcontrib><creatorcontrib>Tarbell, Nancy J.</creatorcontrib><creatorcontrib>Yock, Torunn I.</creatorcontrib><creatorcontrib>Pulsifer, Margaret B.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zureick, Andrew H.</au><au>Evans, Casey L.</au><au>Niemierko, Andrzej</au><au>Grieco, Julie A.</au><au>Nichols, Alexandra J.</au><au>Fullerton, Barbara C.</au><au>Hess, Clayton B.</au><au>Goebel, Claire P.</au><au>Gallotto, Sara L.</au><au>Weyman, Elizabeth A.</au><au>Gaudet, Dillon E.</au><au>Nartowicz, Jessica A.</au><au>Ebb, David H.</au><au>Jones, Robin M.</au><au>MacDonald, Shannon M.</au><au>Tarbell, Nancy J.</au><au>Yock, Torunn I.</au><au>Pulsifer, Margaret B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Left hippocampal dosimetry correlates with visual and verbal memory outcomes in survivors of pediatric brain tumors</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2018-05-15</date><risdate>2018</risdate><volume>124</volume><issue>10</issue><spage>2238</spage><epage>2245</epage><pages>2238-2245</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><abstract>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. © 2018 American Cancer Society.
In this pediatric brain tumor cohort, visual and verbal memory skills after proton radiotherapy are found to be largely stable. However, increased dose to the left hippocampus appears to be predictive of lower follow‐up memory scores.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29499085</pmid><doi>10.1002/cncr.31143</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6030-4343</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Brain Brain cancer Brain tumors Cancer central nervous system (CNS) neoplasms child Children Cognition Correlation analysis Dosimeters Dosimetry Hippocampus learning long‐term memory Memory Oncology Patients Pediatrics proton therapy Radiation therapy Retrieval Risk analysis Risk factors short‐term memory survivors Temporal lobe Tumors verbal learning |
| title | Left hippocampal dosimetry correlates with visual and verbal memory outcomes in survivors of pediatric brain tumors |
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