Comparing intelligence quotient change after treatment with proton versus photon radiation therapy for pediatric brain tumors

Lisa S. Kahalley, M. Douglas Ris, David R. Grosshans, M. Fatih Okcu, Arnold C. Paulino, Murali Chintagumpala, Bartlett D. Moore, Danielle Guffey, Charles G. Minard, Heather H. Stancel, Anita Mahajan

Research output: Contribution to journalArticle

78 Scopus citations

Abstract

Purpose Compared with photon radiation (XRT), proton beamradiation therapy (PBRT) reduces dose to normal tissues, which may lead to better neurocognitive outcomes. We compared change in intelligence quotient (IQ) over time in pediatric patients with brain tumors treated with PBRT versus XRT. Patients and Methods IQ scores were available for 150 patients (60 had received XRT, 90 had received PBRT). Linear mixed models examined change in IQ over time since radiation therapy (RT) by RT group, controlling for demographic/clinical characteristics. Craniospinal and focal RT subgroups were also examined. Results In the PBRT group, no change in IQ over time was identified (P = .130), whereas in the XRT group, IQ declined by 1.1 points per year (P = .004). IQ slopes did not differ between groups (P = .509). IQwas lower in the XRT group (by 8.7 points) versus the PBRT group (P = .011). In the craniospinal subgroup, IQ remained stable in both the PBRT (P = .203) and XRT groups (P = .060), and IQ slopes did not differ (P = .890). IQwas lower in the XRT group (by 12.5 points) versus the PBRT group (P = .004). Inthefocal subgroup, IQ scores remained stable in the PBRT group (P = .401) but declined significantly in the XRT group by 1.57 points per year (P = .026). IQ slopes did not differ between groups (P = .342). Conclusion PBRT was not associated with IQ decline or impairment, yet IQ slopes did not differ between the PBRT and XRT groups. It remains unclear if PBRT results in clinically meaningful cognitive sparing that significantly exceeds that of modern XRT protocols. Additional long-term data are needed to fully understand the neurocognitive impact of PBRT in survivors of pediatric brain tumors.

Original languageEnglish (US)
Pages (from-to)1043-1049
Number of pages7
JournalJournal of Clinical Oncology
Volume34
Issue number10
DOIs
StatePublished - Apr 1 2016

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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