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Title: Modeling radiation dosimetry to predict cognitive outcomes in pediatric patients with CNS embryonal tumors including medulloblastoma

Abstract

Purpose: Model the effects of radiation dosimetry on IQ among pediatric patients with central nervous system (CNS) tumors. Methods and Materials: Pediatric patients with CNS embryonal tumors (n = 39) were prospectively evaluated with serial cognitive testing, before and after treatment with postoperative, risk-adapted craniospinal irradiation (CSI) and conformal primary-site irradiation, followed by chemotherapy. Differential dose-volume data for 5 brain volumes (total brain, supratentorial brain, infratentorial brain, and left and right temporal lobes) were correlated with IQ after surgery and at follow-up by use of linear regression. Results: When the dose distribution was partitioned into 2 levels, both had a significantly negative effect on longitudinal IQ across all 5 brain volumes. When the dose distribution was partitioned into 3 levels (low, medium, and high), exposure to the supratentorial brain appeared to have the most significant impact. For most models, each Gy of exposure had a similar effect on IQ decline, regardless of dose level. Conclusions: Our results suggest that radiation dosimetry data from 5 brain volumes can be used to predict decline in longitudinal IQ. Despite measures to reduce radiation dose and treatment volume, the volume that receives the highest dose continues to have the greatest effect, which supports currentmore » volume-reduction efforts.« less

Authors:
 [1];  [2];  [3];  [2];  [2];  [3];  [4];  [5]
  1. Division of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN (United States). E-mail: thomas.merchant@stjude.org
  2. Division of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN (United States)
  3. Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN (United States)
  4. Department of Hematology Oncology, St. Jude Children's Research Hospital, Memphis, TN (United States)
  5. Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, TN (United States)
Publication Date:
OSTI Identifier:
20793477
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 65; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2005.10.038; PII: S0360-3016(05)02953-6; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; CARCINOMAS; CHEMOTHERAPY; DOSIMETRY; IRRADIATION; PATIENTS; RADIATION DOSE DISTRIBUTIONS; RADIATION DOSES; SURGERY

Citation Formats

Merchant, Thomas E., Kiehna, Erin N., Li Chenghong, Shukla, Hemant, Sengupta, Saikat, Xiong Xiaoping, Gajjar, Amar, and Mulhern, Raymond K. Modeling radiation dosimetry to predict cognitive outcomes in pediatric patients with CNS embryonal tumors including medulloblastoma. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.1.
Merchant, Thomas E., Kiehna, Erin N., Li Chenghong, Shukla, Hemant, Sengupta, Saikat, Xiong Xiaoping, Gajjar, Amar, & Mulhern, Raymond K. Modeling radiation dosimetry to predict cognitive outcomes in pediatric patients with CNS embryonal tumors including medulloblastoma. United States. doi:10.1016/J.IJROBP.2005.1.
Merchant, Thomas E., Kiehna, Erin N., Li Chenghong, Shukla, Hemant, Sengupta, Saikat, Xiong Xiaoping, Gajjar, Amar, and Mulhern, Raymond K. Mon . "Modeling radiation dosimetry to predict cognitive outcomes in pediatric patients with CNS embryonal tumors including medulloblastoma". United States. doi:10.1016/J.IJROBP.2005.1.
@article{osti_20793477,
title = {Modeling radiation dosimetry to predict cognitive outcomes in pediatric patients with CNS embryonal tumors including medulloblastoma},
author = {Merchant, Thomas E. and Kiehna, Erin N. and Li Chenghong and Shukla, Hemant and Sengupta, Saikat and Xiong Xiaoping and Gajjar, Amar and Mulhern, Raymond K.},
abstractNote = {Purpose: Model the effects of radiation dosimetry on IQ among pediatric patients with central nervous system (CNS) tumors. Methods and Materials: Pediatric patients with CNS embryonal tumors (n = 39) were prospectively evaluated with serial cognitive testing, before and after treatment with postoperative, risk-adapted craniospinal irradiation (CSI) and conformal primary-site irradiation, followed by chemotherapy. Differential dose-volume data for 5 brain volumes (total brain, supratentorial brain, infratentorial brain, and left and right temporal lobes) were correlated with IQ after surgery and at follow-up by use of linear regression. Results: When the dose distribution was partitioned into 2 levels, both had a significantly negative effect on longitudinal IQ across all 5 brain volumes. When the dose distribution was partitioned into 3 levels (low, medium, and high), exposure to the supratentorial brain appeared to have the most significant impact. For most models, each Gy of exposure had a similar effect on IQ decline, regardless of dose level. Conclusions: Our results suggest that radiation dosimetry data from 5 brain volumes can be used to predict decline in longitudinal IQ. Despite measures to reduce radiation dose and treatment volume, the volume that receives the highest dose continues to have the greatest effect, which supports current volume-reduction efforts.},
doi = {10.1016/J.IJROBP.2005.1},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 65,
place = {United States},
year = {Mon May 01 00:00:00 EDT 2006},
month = {Mon May 01 00:00:00 EDT 2006}
}