Neurocognitive Outcomes in Pediatric Patients Following Brain Irradiation
Advanced radiation techniques can reduce the severity of neurocognitive sequelae in young brain tumor patients. In the present analysis, we sought to compare neurocognitive outcomes after proton irradiation with patients who underwent photon radiotherapy (RT) and surgery. Neurocognitive outcomes wer...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/14/3538 |
| _version_ | 1797527470349484032 |
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| author | Katharina Weusthof Peggy Lüttich Sebastian Regnery Laila König Denise Bernhardt Olaf Witt Klaus Herfarth Andreas Unterberg Christine Jungk Benjamin Farnia Stephanie E. Combs Jürgen Debus Stefan Rieken Semi Harrabi Sebastian Adeberg |
| author_facet | Katharina Weusthof Peggy Lüttich Sebastian Regnery Laila König Denise Bernhardt Olaf Witt Klaus Herfarth Andreas Unterberg Christine Jungk Benjamin Farnia Stephanie E. Combs Jürgen Debus Stefan Rieken Semi Harrabi Sebastian Adeberg |
| author_sort | Katharina Weusthof |
| collection | DOAJ |
| description | Advanced radiation techniques can reduce the severity of neurocognitive sequelae in young brain tumor patients. In the present analysis, we sought to compare neurocognitive outcomes after proton irradiation with patients who underwent photon radiotherapy (RT) and surgery. Neurocognitive outcomes were evaluated in 103 pediatric brain tumor patients (proton RT <i>n</i> = 26, photon RT <i>n</i> = 30, surgery <i>n</i> = 47) before and after treatment. Comparison of neurocognitive outcomes following different treatment modalities were analyzed over four years after treatment completion. Longitudinal analyses included 42 months of follow-up after proton RT and 55 months after photon RT and surgery. Neurocognitive assessment included standardized tests examining seven domains. A comparison of neurocognitive outcomes after RT (proton and photon with >90% additional surgery) and surgery showed no significant differences in any neurocognitive domain. Neurocognitive functioning tests after proton RT failed to identify alterations compared to baseline testing. Long-term follow up over four years after photon RT showed a decrease in non-verbal intelligence (−9.6%; <i>p</i> = 0.01) and visuospatial construction (−14.9%; <i>p</i> = 0.02). After surgery, there was a decline in non-verbal intelligence (−10.7%; <i>p</i> = 0.01) and processing speed (14.9%; <i>p</i> = 0.002). Differences in neurocognitive outcomes between RT and surgical cohorts in direct intermodal comparison at long-term follow-up were not identified in our study, suggesting that modern radiation therapy does not affect cognition as much as in the past. There were no alterations in long-term neurocognitive abilities after proton RT, whereas decline of processing speed, non-verbal intelligence, and visuospatial abilities were observed after both photon RT and surgery. Domains dependent on intact white matter structures appear particularly vulnerable to brain tumor treatment irrespective of treatment approach. |
| first_indexed | 2024-03-10T09:44:14Z |
| format | Article |
| id | doaj.art-951e402cad2442049c4270db95ffafcf |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T09:44:14Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-951e402cad2442049c4270db95ffafcf2023-11-22T03:24:57ZengMDPI AGCancers2072-66942021-07-011314353810.3390/cancers13143538Neurocognitive Outcomes in Pediatric Patients Following Brain IrradiationKatharina Weusthof0Peggy Lüttich1Sebastian Regnery2Laila König3Denise Bernhardt4Olaf Witt5Klaus Herfarth6Andreas Unterberg7Christine Jungk8Benjamin Farnia9Stephanie E. Combs10Jürgen Debus11Stefan Rieken12Semi Harrabi13Sebastian Adeberg14Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, GermanySection of Pediatric Brain Tumors, Department of Pediatric Oncology, Hematology and Immunology, University Medical Center for Children and Adolescents, 69120 Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Radiation Oncology, Technische Universität München, 81675 München, GermanySection of Pediatric Brain Tumors, Department of Pediatric Oncology, Hematology and Immunology, University Medical Center for Children and Adolescents, 69120 Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Neurosurgery, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Neurosurgery, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USADepartment of Radiation Oncology, Technische Universität München, 81675 München, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Radiation Oncology, University Hospital Goettingen, 37075 Goettingen, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, GermanyAdvanced radiation techniques can reduce the severity of neurocognitive sequelae in young brain tumor patients. In the present analysis, we sought to compare neurocognitive outcomes after proton irradiation with patients who underwent photon radiotherapy (RT) and surgery. Neurocognitive outcomes were evaluated in 103 pediatric brain tumor patients (proton RT <i>n</i> = 26, photon RT <i>n</i> = 30, surgery <i>n</i> = 47) before and after treatment. Comparison of neurocognitive outcomes following different treatment modalities were analyzed over four years after treatment completion. Longitudinal analyses included 42 months of follow-up after proton RT and 55 months after photon RT and surgery. Neurocognitive assessment included standardized tests examining seven domains. A comparison of neurocognitive outcomes after RT (proton and photon with >90% additional surgery) and surgery showed no significant differences in any neurocognitive domain. Neurocognitive functioning tests after proton RT failed to identify alterations compared to baseline testing. Long-term follow up over four years after photon RT showed a decrease in non-verbal intelligence (−9.6%; <i>p</i> = 0.01) and visuospatial construction (−14.9%; <i>p</i> = 0.02). After surgery, there was a decline in non-verbal intelligence (−10.7%; <i>p</i> = 0.01) and processing speed (14.9%; <i>p</i> = 0.002). Differences in neurocognitive outcomes between RT and surgical cohorts in direct intermodal comparison at long-term follow-up were not identified in our study, suggesting that modern radiation therapy does not affect cognition as much as in the past. There were no alterations in long-term neurocognitive abilities after proton RT, whereas decline of processing speed, non-verbal intelligence, and visuospatial abilities were observed after both photon RT and surgery. Domains dependent on intact white matter structures appear particularly vulnerable to brain tumor treatment irrespective of treatment approach.https://www.mdpi.com/2072-6694/13/14/3538pediatric brain tumorproton irradiationphoton irradiationtreatment modality comparisonneuropsychological assessmentneurocognitive function |
| spellingShingle | Katharina Weusthof Peggy Lüttich Sebastian Regnery Laila König Denise Bernhardt Olaf Witt Klaus Herfarth Andreas Unterberg Christine Jungk Benjamin Farnia Stephanie E. Combs Jürgen Debus Stefan Rieken Semi Harrabi Sebastian Adeberg Neurocognitive Outcomes in Pediatric Patients Following Brain Irradiation Cancers pediatric brain tumor proton irradiation photon irradiation treatment modality comparison neuropsychological assessment neurocognitive function |
| title | Neurocognitive Outcomes in Pediatric Patients Following Brain Irradiation |
| title_full | Neurocognitive Outcomes in Pediatric Patients Following Brain Irradiation |
| title_fullStr | Neurocognitive Outcomes in Pediatric Patients Following Brain Irradiation |
| title_full_unstemmed | Neurocognitive Outcomes in Pediatric Patients Following Brain Irradiation |
| title_short | Neurocognitive Outcomes in Pediatric Patients Following Brain Irradiation |
| title_sort | neurocognitive outcomes in pediatric patients following brain irradiation |
| topic | pediatric brain tumor proton irradiation photon irradiation treatment modality comparison neuropsychological assessment neurocognitive function |
| url | https://www.mdpi.com/2072-6694/13/14/3538 |
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