PMID- 30108004
OWN - NLM
STAT- MEDLINE
DCOM- 20190109
LR  - 20190109
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 102
IP  - 2
DP  - 2018 Oct 1
TI  - Cognitive and Adaptive Outcomes After Proton Radiation for Pediatric Patients
      With Brain Tumors.
PG  - 391-398
LID - S0360-3016(18)30922-2 [pii]
LID - 10.1016/j.ijrobp.2018.05.069 [doi]
AB  - PURPOSE: Radiation therapy is integral in treatment of pediatric brain tumors,
      but it is associated with negative long-term sequelae. Proton beam radiation
      therapy (PRT), which enables better focusing of radiation on tumors, may entail
      fewer sequelae. This prospective study examined cognitive and adaptive
      functioning in children and young adults treated with PRT. METHODS AND MATERIALS:
      A total of 155 patients were assessed using age-appropriate measures for
      cognitive and adaptive functioning at start of or during PRT (baseline) and at
      follow-up. Mean age at baseline was 8.9 years; mean follow-up interval was 3.6
      years. Diagnoses included medulloblastoma, craniopharyngioma, ependymoma, glial
      tumors, germ cell tumors, and others. The sample was divided by age at baseline
      (<6 years [N = 57, or 37%] and >/=6 years [N = 98, or 63%]) and by PRT field
      (craniospinal irradiation [CSI; 39%] and focal irradiation [61%]). RESULTS:
      Scores for mean intelligence quotient (IQ) and adaptive functioning skills were
      in the average range at baseline and follow-up. Overall, mean IQ scores declined 
      from 105.4 to 102.5 (P = .005); however, only the younger CSI group showed
      significant decline. Patients receiving CSI, regardless of age, appeared
      particularly vulnerable in IQ, processing speed, and working memory. Adaptive
      skills were stable across the 4 age-by-treatment field groups. CONCLUSIONS: At a 
      mean of 3.6 years after PRT, IQ declined slightly for the group, largely because 
      of significant IQ decline in younger patients treated with CSI. No significant
      change was seen in patients <6 years treated with focal PRT or in older patients.
      Adaptive skills remained stable across age and treatment type.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Pulsifer, Margaret B
AU  - Pulsifer MB
AD  - Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; 
      Harvard Medical School, Harvard University, Boston, Massachusetts. Electronic
      address: mpulsifer@mgh.harvard.edu.
FAU - Duncanson, Haley
AU  - Duncanson H
AD  - Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; 
      Harvard Medical School, Harvard University, Boston, Massachusetts.
FAU - Grieco, Julie
AU  - Grieco J
AD  - Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; 
      Harvard Medical School, Harvard University, Boston, Massachusetts.
FAU - Evans, Casey
AU  - Evans C
AD  - Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
FAU - Tseretopoulos, Irene Delgado
AU  - Tseretopoulos ID
AD  - Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
FAU - MacDonald, Shannon
AU  - MacDonald S
AD  - Harvard Medical School, Harvard University, Boston, Massachusetts; Department of 
      Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.
FAU - Tarbell, Nancy J
AU  - Tarbell NJ
AD  - Harvard Medical School, Harvard University, Boston, Massachusetts; Department of 
      Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.
FAU - Yock, Torunn I
AU  - Yock TI
AD  - Harvard Medical School, Harvard University, Boston, Massachusetts; Department of 
      Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.
LA  - eng
SI  - ClinicalTrials.gov/NCT01180881
GR  - P01 CA021239/CA/NCI NIH HHS/United States
GR  - C06 CA059267/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20180606
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Adaptation, Physiological
MH  - Adolescent
MH  - Age Factors
MH  - Analysis of Variance
MH  - Brain Neoplasms/*radiotherapy
MH  - Child
MH  - Child, Preschool
MH  - Cognition/physiology/*radiation effects
MH  - Craniopharyngioma/radiotherapy
MH  - Craniospinal Irradiation/*adverse effects/methods
MH  - Ependymoma/radiotherapy
MH  - Female
MH  - Glioma/radiotherapy
MH  - Humans
MH  - Infant
MH  - Intelligence/physiology/*radiation effects
MH  - Male
MH  - Medulloblastoma/radiotherapy
MH  - Neoplasms, Germ Cell and Embryonal/radiotherapy
MH  - Prospective Studies
MH  - Proton Therapy/*adverse effects/methods
MH  - Young Adult
EDAT- 2018/08/16 06:00
MHDA- 2019/01/10 06:00
CRDT- 2018/08/16 06:00
PHST- 2017/12/28 00:00 [received]
PHST- 2018/05/24 00:00 [revised]
PHST- 2018/05/28 00:00 [accepted]
PHST- 2018/08/16 06:00 [pubmed]
PHST- 2019/01/10 06:00 [medline]
PHST- 2018/08/16 06:00 [entrez]
AID - S0360-3016(18)30922-2 [pii]
AID - 10.1016/j.ijrobp.2018.05.069 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2018 Oct 1;102(2):391-398. doi:
      10.1016/j.ijrobp.2018.05.069. Epub 2018 Jun 6.