QOL-11. COMPARISON OF TREATMENT BURDEN RATING SCALES ON NEUROCOGNITIVE OUTCOMES IN A MIXED SAMPLE OF PEDIATRIC BRAIN TUMOR SURVIVORS

Abstract BACKGROUND Predicting neurocognitive outcomes in pediatric brain tumor (PBT) patients is challenging. Rarity of PBT makes inclusion of detailed risk factors (e.g., treatment modality, intensity, individual complications) difficult when sample sizes are small. The Neurological Predictor Scale (NPS) summarizes complications and treatment factors associated with neurocognitive risks and has modest validation. Recently, the Pediatric Neuro-Oncology Rating of Treatment Intensity (PNORTI) was developed to evaluate the impact of treatment intensity on psychosocial outcomes but has not been compared to neurocognitive outcomes. This study compared the NPS and PNORTI in terms of relationship to neurocognitive outcomes known to be at risk in PBT survivors. METHODS 88 PBT survivors’ neuropsychological outcomes were retrospectively analyzed in relation to the NPS and PNORTI. Variables of interest included IQ, working memory, and processing speed. RESULTS NPS associated with lower IQ (rs=-.476, p=.001), lower working memory (rs=-.323, p=.010), and lower processing speed (rs=-.389, p=.007) in patients diagnosed at a younger age, but only processing speed for children diagnosed after age 7 years (rs=-.262, p=.036). PNORTI was not correlated with neurocognitive variables for either group. CONCLUSION NPS has value in predicting neurocognitive outcomes, though much more in a younger age at diagnosis group compared to older patients. The PNORTI did not demonstrate predictive value for these neurocognitive domains in our sample. Given the potential clinical and research value of a summary rating of treatment burden relating to long-term outcome, future research should include relationship to psychosocial outcomes and quality of life.

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Working memory and processing speed among pediatric brain tumor patients treated with photon or proton beam radiation therapy

Children s Health Care ◽

10.1080/02739615.2018.1510330 ◽

2018 ◽

Vol 48 (2) ◽

pp. 131-141 ◽

Cited By ~ 2

Author(s):

Rachel K. Peterson ◽

Jennifer M. Katzenstein

Keyword(s):

Working Memory ◽

Radiation Therapy ◽

Brain Tumor ◽

Processing Speed ◽

Pediatric Brain Tumor ◽

Tumor Patients ◽

Beam Radiation ◽

Proton Beam Radiation ◽

Pediatric Brain ◽

Proton Beam Radiation Therapy

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Working memory and attention in pediatric brain tumor patients treated with and without radiation therapy

Child Neuropsychology ◽

10.1080/09297049.2016.1183608 ◽

2016 ◽

Vol 23 (6) ◽

pp. 642-654 ◽

Cited By ~ 9

Author(s):

Kimberly P. Raghubar ◽

E. Mark Mahone ◽

Keith Owen Yeates ◽

Kim M. Cecil ◽

Monwabisi Makola ◽

...

Keyword(s):

Working Memory ◽

Radiation Therapy ◽

Brain Tumor ◽

Pediatric Brain Tumor ◽

Tumor Patients ◽

Memory And Attention ◽

Pediatric Brain

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Improved neuropsychological outcomes following proton therapy relative to X-ray therapy for pediatric brain tumor patients

Neuro-Oncology ◽

10.1093/neuonc/noz070 ◽

2019 ◽

Vol 21 (7) ◽

pp. 934-943 ◽

Cited By ~ 18

Author(s):

Jeffrey P Gross ◽

Stephanie Powell ◽

Frank Zelko ◽

William Hartsell ◽

Stewart Goldman ◽

...

Keyword(s):

Brain Tumor ◽

Processing Speed ◽

Adaptive Functioning ◽

Pediatric Brain Tumor ◽

Neuropsychological Evaluation ◽

Tumor Patients ◽

X Ray ◽

Neuropsychological Outcomes ◽

Pediatric Brain

AbstractBackgroundSurvivors of pediatric brain tumors are at risk for impaired development in multiple neuropsychological domains. The purpose of this study was to compare neuropsychological outcomes of pediatric brain tumor patients who underwent X-ray radiotherapy (XRT) versus proton radiotherapy (PRT).MethodsPediatric patients who underwent either XRT or PRT and received posttreatment age-appropriate neuropsychological evaluation—including measures of intelligence (IQ), attention, memory, visuographic skills, academic skills, and parent-reported adaptive functioning—were identified. Multivariate analyses were performed to assess differences in neuropsychological outcomes and included tests for interaction between treatment cohort and follow-up time.ResultsBetween 1998 and 2017, 125 patients with tumors located in the supratentorial (17.6%), midline (28.8%), or posterior fossa (53.6%) compartments received radiation and had posttreatment neuropsychological evaluation. Median age at treatment was 7.4 years. The PRT patient cohort had higher estimated SES and shorter median time from radiotherapy completion to last neuropsychological evaluation (6.7 vs 2.6 y, P < 0.001). On multivariable analysis, PRT was associated with higher full-scale IQ (β = 10.6, P = 0.048) and processing speed (β = 14.4, P = 0.007) relative to XRT, with trend toward higher verbal IQ (β = 9.9, P = 0.06) and general adaptive functioning (β = 11.4, P = 0.07). Planned sensitivity analyses truncating follow-up interval in the XRT cohort re-demonstrated higher verbal IQ (P = 0.01) and IQ (P = 0.04) following PRT, with trend toward improved processing speed (P = 0.09).ConclusionsPRT is associated with favorable outcomes for intelligence and processing speed. Combined with other strategies for treatment de-intensification, PRT may further reduce neuropsychological morbidity of brain tumor treatment.

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Comparing Endocrine and Neurocognitive Outcomes in Pediatric Brain Tumor Patients Treated with Proton vs Photon Radiation

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2020.07.1518 ◽

2020 ◽

Vol 108 (3) ◽

pp. e237-e238

Author(s):

A.T.T. Yip ◽

M.P. Huynh-Le ◽

J. Crawford ◽

R. Kaner ◽

I. MacEwan ◽

...

Keyword(s):

Brain Tumor ◽

Pediatric Brain Tumor ◽

Photon Radiation ◽

Tumor Patients ◽

Neurocognitive Outcomes ◽

Pediatric Brain

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QOL-47. ApoE4 AS A GENETIC PREDICTOR FOR NEUROCOGNITIVE OUTCOMES IN PEDIATRIC BRAIN TUMOR SURVIVORS

Neuro-Oncology ◽

10.1093/neuonc/noy059.629 ◽

2018 ◽

Vol 20 (suppl_2) ◽

pp. i167-i167

Author(s):

Cassie Kline ◽

Erin Felton ◽

Lennox Byer ◽

Schuyler Stoller ◽

Joseph Torkildson ◽

...

Keyword(s):

Brain Tumor ◽

Pediatric Brain Tumor ◽

Genetic Predictor ◽

Neurocognitive Outcomes ◽

Pediatric Brain

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Proton beam therapy in pediatric brain tumor patients: improved radiation delivery techniques improve neurocognitive outcomes

Neuro-Oncology ◽

10.1093/neuonc/noz085 ◽

2019 ◽

Vol 21 (7) ◽

pp. 830-831 ◽

Cited By ~ 1

Author(s):

Rakesh Jalali ◽

Jayant S Goda

Keyword(s):

Brain Tumor ◽

Proton Beam ◽

Pediatric Brain Tumor ◽

Proton Beam Therapy ◽

Tumor Patients ◽

Radiation Delivery ◽

Neurocognitive Outcomes ◽

Pediatric Brain ◽

Delivery Techniques

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Feasibility and efficacy of an extended trial of home-based working memory training for pediatric brain tumor survivors: a pilot study

Neuro-Oncology Practice ◽

10.1093/nop/npw015 ◽

2016 ◽

Vol 4 (2) ◽

pp. 111-120 ◽

Cited By ~ 3

Author(s):

Bonnie Carlson-Green ◽

Jennifer Puig ◽

Anne Bendel

Keyword(s):

Working Memory ◽

Brain Tumor ◽

Executive Functioning ◽

Late Effects ◽

Pediatric Brain Tumor ◽

Working Memory Training ◽

Memory Training ◽

Neurocognitive Late Effects ◽

Pediatric Brain

Abstract Background. Impaired working memory appears to play a key role in some of the neurocognitive late effects of pediatric brain tumor treatments, including declines in intellectual and executive functioning. Recent studies of pediatric cancer survivors suggest Cogmed® Working Memory Training is effective at improving working memory, although pediatric brain tumor survivors may demonstrate a less robust response than children with other cancers. The current study sought to determine if an extended course of Cogmed (35 sessions) was both feasible and efficacious for brain tumor survivors and if improvements were observable in near-transfer and far-transfer working memory measures as well as parent rating scores at 6 months post-treatment. Methods. Twenty pediatric brain tumor survivors ages 8 to 18 years with working memory deficits completed 35 sessions of Cogmed. Assessments of working memory and academic skills were completed at baseline, completion of training, and 6-month follow-up and parents completed questionnaires at baseline and 6-month follow-up. Results. Participants showed significant improvements in working memory at training completion and 6-month follow-up and math achievement at 6-month follow-up. Parents reported executive functioning improvements at follow-up as compared with baseline. Participants’ program-based working memory skills did not change significantly between sessions 25 and 35, suggesting that extended training did not provide additional benefit. Conclusions. This study replicates and extends previous research by: (1) demonstrating that brain tumor survivors at high risk for neurocognitive late effects can complete and benefit from working memory training, (2) identifying a point of diminished returns on training time investment, and (3) demonstrating benefits 6 months post-intervention.

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