TY - JOUR
T1 - Long-term intellectual outcome in children with posterior fossa tumors according to radiation doses and volumes
AU - Grill, Jacques
AU - Renaux, Virginie Kieffer
AU - Bulteau, Christine
AU - Viguier, Delphine
AU - Levy-Piebois, Christine
AU - Sainte-Rose, Christian
AU - Dellatolas, Georges
AU - Raquin, Marie Anne
AU - Jambaqué, Isabelle
AU - Kalifa, Chantal
N1 - Funding Information:
Supported by grants of the Comité de Recherche Clinique - IGR 1996 and 1997.
PY - 1999/8/1
Y1 - 1999/8/1
N2 - Purpose: To analyze the relationship between craniospinal irradiation (CSI) and intellectual outcome in children with posterior fossa (PF) tumors. Methods and Materials: A neuropsychological evaluation was performed retrospectively in 31 children, aged 5-15 years, who had received radiotherapy for PF tumors, and who had been off therapy for at least 1 year. Factors evaluated for impact on intellectual outcome were: socioeconomic status, disease presentation, histology, complications, chemotherapy, age at radiotherapy, interval between radiotherapy and testing, and radiation doses and volumes. Patients were divided into 3 subgroups according to the CSI doses (0 Gy [ i.e., PF irradiation only], 25 Gy, and 35 Gy), with 11, 11, and 9 patients, respectively. Results: Long-term cognitive impairment occurred in most of the patients, even after PF irradiation only. Moreover, there was a significant correlation between the full-scale IQ score (FSIQ) and the CSI dose, with mean FSIQ scores at 84.5 (SD = 14.0), 76.9 (SD = 16.6), and 63.7 (SD = 15.4) for 0 Gy, 25 Gy, and 35 Gy of CSI, respectively. A marked drop in verbal comprehension scores was noted in children who had received the higher dose. Conclusion: This preliminary study further supports the rationale for de-escalation of CSI doses and volumes in standard-risk PF tumors.
AB - Purpose: To analyze the relationship between craniospinal irradiation (CSI) and intellectual outcome in children with posterior fossa (PF) tumors. Methods and Materials: A neuropsychological evaluation was performed retrospectively in 31 children, aged 5-15 years, who had received radiotherapy for PF tumors, and who had been off therapy for at least 1 year. Factors evaluated for impact on intellectual outcome were: socioeconomic status, disease presentation, histology, complications, chemotherapy, age at radiotherapy, interval between radiotherapy and testing, and radiation doses and volumes. Patients were divided into 3 subgroups according to the CSI doses (0 Gy [ i.e., PF irradiation only], 25 Gy, and 35 Gy), with 11, 11, and 9 patients, respectively. Results: Long-term cognitive impairment occurred in most of the patients, even after PF irradiation only. Moreover, there was a significant correlation between the full-scale IQ score (FSIQ) and the CSI dose, with mean FSIQ scores at 84.5 (SD = 14.0), 76.9 (SD = 16.6), and 63.7 (SD = 15.4) for 0 Gy, 25 Gy, and 35 Gy of CSI, respectively. A marked drop in verbal comprehension scores was noted in children who had received the higher dose. Conclusion: This preliminary study further supports the rationale for de-escalation of CSI doses and volumes in standard-risk PF tumors.
KW - Ependymoma
KW - Intelligence quotient
KW - Irradiation
KW - Medulloblastoma
KW - Neuropsychological sequelae
UR - http://www.scopus.com/inward/record.url?scp=0032797110&partnerID=8YFLogxK
U2 - 10.1016/S0360-3016(99)00177-7
DO - 10.1016/S0360-3016(99)00177-7
M3 - Article
C2 - 10477017
AN - SCOPUS:0032797110
SN - 0360-3016
VL - 45
SP - 137
EP - 145
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 1
ER -