Neurocognitive Functions Before and After Radiotherapy in Pediatric Brain Tumor Survivors

Söderström, Helena; Brocki, Karin C.; Kleberg, Johan Lundin; Martinsson, Ulla; Ljungman, Gustaf

doi:10.1016/j.pediatrneurol.2022.05.006

Cited by 11 publications

(14 citation statements)

References 29 publications

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“…in our previous study [7]. Prescribed doses or planning target volumes are common measures for investigating neurocognitive late effects [7,8]. In our previous study, we found that higher dose to planning target volume was moderately correlated with one IQ subtest that measures working memory [7].…”

mentioning

confidence: 80%

“…Prescribed doses or planning target volumes are common measures for investigating neurocognitive late effects [7,8]. In our previous study, we found that higher dose to planning target volume was moderately correlated with one IQ subtest that measures working memory [7]. However, physical mean dose metrics account for dose heterogeneity and may be a better predictor for RT-induced neurocognitive decline [8,9].…”

mentioning

confidence: 92%

“…in our previous study [7]. Prescribed doses or planning target volumes are common measures for investigating neurocognitive late effects [7,8].…”

mentioning

confidence: 96%

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Neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk?

et al. 2023

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Background Children with brain tumors are at high risk of neurocognitive decline after radiotherapy (RT). However, there is a lack of studies on how RT doses to organs at risk (OARs) impacts neurocognition. The aim of this study was to examine dose-risk relationships for mean RT dose to different brain structures important for neurocognitive networks. We explored previously established OARs and potentially new OARs. Methods A sample of 44 pediatric brain tumor survivors who had received proton and/or photon RT were included. Correlations between mean RT doses to OARs and IQ were analyzed. Previously established OARs were cochleae, optic chiasm, optic nerve, pituitary gland, hypothalamus, hippocampus and pons. Potential new OARs for RT-induced neurocognitive decline were cerebellum, vermis and thalamus. Results Mean RT dose to different OARs correlated with several IQ subtests. Higher mean RT dose to cochleae, optic nerve, cerebellum, vermis and pons was correlated with lower performance on particularly full-scale IQ (FIQ), Perceptual Reasoning (PRI), Working Memory (WMI) and Processing Speed Index (PSI). Higher mean RT dose to hippocampus correlated with lower performance on processing speed and working memory. For those receiving whole brain RT (WBRT), higher mean RT dose to the pituitary gland correlated with lower performance on working memory. Conclusion A high dose-risk correlation was found between IQ subtests and mean RT dose in established and potential new OARs. Thus, in the lack of validated dose constraints for vulnerable brain structures, a parsimonious approach in RT planning should be considered to preserve neurocognitive networks.

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confidence: 80%

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confidence: 92%

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Neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk?

et al. 2023

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“…Comprehensive neuropsychological assessment and neurological reports reveal more and more diverse problems than could be inferred from the IQ measurements alone, which is no more sufficient in this complex interaction [ 89 ].…”

Section: Strategy Of Monitoring and Potential Interventionmentioning

confidence: 99%

“…When possible, according to the clinical and psychological conditions of children, a pre-surgical evaluation is suggested to establish a baseline of neurodevelopment. Some recent studies also underline the importance of a structured neuropsychological evaluation before and after radiotherapy to better evaluate RT-induced neurocognitive decline [ 89 ].…”

Section: Strategy Of Monitoring and Potential Interventionmentioning

confidence: 99%

Neuropsychological Outcomes of Children Treated for Brain Tumors

Pancaldi

Pugliese²,

Migliozzi³

et al. 2023

Children

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Central nervous system (CNS) neoplasms are the most common solid tumors diagnosed in children. CNS tumors represent the leading cause of cancer death and cancer-related morbidity for children less than 20 years of age, although there has been a moderate increase in survival rates over the past several decades. The average survival at 5 years now nearly reaches 75%, and for some, non-malignant histology approximates 97% at 20 years from diagnosis. Neurological, cognitive, and neuropsychological deficits are the most disabling long-term effects of brain tumors in children. Childhood is a time of extreme brain sensitivity and the time of life in which most brain development occurs. Thus, the long-term toxicities that children treated for CNS tumors experience can affect multiple developmental domains and day-to-day functioning, ultimately leading to a poor quality of survival (QoS). We reviewed literature focusing on the risk factors for cognitive and neuropsychological impairment in pediatric patients treated for brain tumors with the aim of better understanding who is at major risk and what the best strategies for monitoring these patients are.

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The development of fatigue after treatment for pediatric brain tumors does not differ between tumor locations

Irestorm,

Schouten‐van Meeteren,

van Gorp

et al. 2024

Pediatric Blood & Cancer

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BackgroundChildren and adolescents treated for a brain tumor suffer from more fatigue than survivors of other types of childhood cancer. As tumor location might be predictive of fatigue, our aim was to investigate the longitudinal development of fatigue in children with brain tumors and risk factors for fatigue separately for different tumor locations.MethodsFatigue was assessed 1235 times for 425 participants. Self‐report versions of PedsQL Multidimensional Fatigue Scale were used to repeatedly assess fatigue from the end of treatment up to 8 years later. Mixed models were used to analyze fatigue over time and determinants separately for infratentorial (N = 205), supratentorial hemispheric (N = 91), and supratentorial midline tumors (N = 129).ResultsCognitive fatigue worsened with time, while sleep‐rest and general fatigue first decreased and then increased. There was no difference in fatigue between the tumor locations, but the risk factors differed when stratified by location. Radiotherapy was associated with more fatigue for infratentorial tumors, and centralization of care was associated with less fatigue for the supratentorial midline tumors. For supratentorial hemispheric tumors, female sex was associated with more fatigue. Higher parental education was associated with less fatigue regardless of tumor location.ConclusionsThe development of fatigue seems to be more related to sociodemographic and treatment variables than to tumor location. Healthcare providers need to be aware that fatigue may develop in the years following end of treatment, and that patients with a low/middle educational family background might be more vulnerable and in need of targeted support.

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Neurocognitive Functions Before and After Radiotherapy in Pediatric Brain Tumor Survivors

Cited by 11 publications

References 29 publications

Neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk?

Neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk?

Neuropsychological Outcomes of Children Treated for Brain Tumors

The development of fatigue after treatment for pediatric brain tumors does not differ between tumor locations

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