RONC-04. PROSPECTIVE, LONGITUDINAL STUDY OF NEUROCOGNITIVE CHANGE IN PEDIATRIC BRAIN TUMOR PATIENTS TREATED WITH PROTON BEAM RADIOTHERAPY VERSUS SURGERY ONLY

• Published in: Neuro-oncology (Charlottesville, Va.) Va.), 2018-06, Vol.20 (suppl_2), p.i175-i175
• Main Authors: Kahalley, Lisa S, Mahajan, Anita, Fatih Okcu, M, Chintagumpala, Murali, Douglas Ris, M, Paulino, Arnold C, Minard, Charles, Whitehead, William, Warren, Emily A, Orobio, Jessica, Xue, Judy J, Grosshans, David R
• Format: Article
• Language: English
• Subjects: Abstracts
• ISSN: 1522-8517; 1523-5866
• DOI: 10.1093/neuonc/noy059.666

Abstract OBJECTIVE Proton radiotherapy (PRT) reduces the volume of normal tissue receiving radiation dose, which may lead to better neurocognitive outcomes. We examined change in neurocognitive scores over time in pediatric brain tumor patients treated with craniospinal PRT (P-CSI), focal PRT (P-Focal), or Surgery Only (SO). METHODS Patients received annual neurocognitive evaluations for up to 5 years. We examined Full Scale IQ (FSIQ), Verbal Comprehension (VC), Perceptual Reasoning (PR), Working Memory (WM), and Processing Speed (PS) scores. Separate general linear mixed models examined change in scores over time by treatment group. RESULTS 83 patients (19 P-CSI, 26 P-Focal, 38 SO) were examined. Groups were compared on demographic/clinical variables (49.4% male, 34.9% infratentorial, mean age-at-treatment=9.7 years, mean follow-up interval=2.8 years). Tumor types included: 54.2% glioma, 18.1% PNET/medulloblastoma, 6.0% ependymoma, 7.2% germ cell, 7.2% craniopharyngioma, and 7.2% other. Median RT dose to tumor bed was 54.0 Gy (P-CSI) and 50.4 Gy (P-Focal). All index scores remained stable in P-Focal and SO groups (all p>0.05). WM, PS, and FSIQ scores declined significantly in the P-CSI group (p=0.04, 0.01, 0.02). The P-CSI group showed significantly greater decline in PS and FSIQ scores compared to P-Focal and SO groups (all p