skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Neuroplastic Response After Radiation Therapy for Pediatric Brain Tumors: A Pilot Study

Abstract

Purpose: Clinically effective measurement of cognitive toxicity from photon radiation therapy (XRT) should be accurate, sensitive, and specific. This pilot study tested translational findings on phasic changes in children's memory systems that are sensitive and insensitive to toxic XRT effects to identify a possible neuroplastic effect. Methods and Materials: Memory processes were prospectively tested before XRT and at 3 later time points up to 2 years in 35 children with mixed primary brain tumors who had not experienced recurrence. Memory processes were verbal-semantic, visual-semantic, and visual-perceptual, including accuracy, speed to recall, encoding, retrieval, and recognition. The mixed-effects model included time (to estimate slope), covariates (age, tumor locus, XRT field, and medications) as fixed effects, and individual random intercepts. A sensitivity analysis examined the influence of XRT dose to the hippocampi on memory. Results: Retrieval from long-term verbal-semantic memory declined 2 months after completing XRT, as seen in adults, and was lowest at 1 year, which was delayed in comparison with adults. Double dissociation from visual-perceptual memory at baseline and 2 months was found, consistent with adults. Recovery was demonstrated 2 years after XRT. Patterns were unchanged when dose to hippocampus was included in the model. Conclusions: Verbal and semantic long-term retrieval is specifically sensitive tomore » XRT-related cognitive dysfunction, without effect on visual-perceptual memory. Children reached nadir in XRT-sensitive memory 1 year after XRT and recovered by 2 years, which is later than that observed in adults. The protracted period of post-XRT injury may represent the maturation of the human hippocampus and white matter into late adolescence.« less

Authors:
 [1];  [1];  [2];  [3]; ;  [1]; ;  [3];  [1]
  1. Neuro-Oncology Section, Children's Hospital of Philadelphia, and Department of Pediatrics, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania (United States)
  2. Oncology Division, Children's Hospital of Philadelphia, and Department of Biostatistics and Epidemiology, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania (United States)
  3. Department of Radiation Oncology, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania (United States)
Publication Date:
OSTI Identifier:
22648712
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 95; Journal Issue: 3; Other Information: Copyright (c) 2016 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; ADULTS; BRAIN; CHILDREN; NEOPLASMS; RADIOSENSITIVITY; RADIOTHERAPY; SENSITIVITY ANALYSIS; SURVIVAL TIME

Citation Formats

Armstrong, Carol L., E-mail: armstrongc@email.chop.edu, Fisher, Michael J., Li, Yimei, Lustig, Robert A., Belasco, Jean B., Minturn, Jane E., Hill-Kayser, Christine E., Batra, Sonny, and Phillips, Peter C. Neuroplastic Response After Radiation Therapy for Pediatric Brain Tumors: A Pilot Study. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.01.013.
Armstrong, Carol L., E-mail: armstrongc@email.chop.edu, Fisher, Michael J., Li, Yimei, Lustig, Robert A., Belasco, Jean B., Minturn, Jane E., Hill-Kayser, Christine E., Batra, Sonny, & Phillips, Peter C. Neuroplastic Response After Radiation Therapy for Pediatric Brain Tumors: A Pilot Study. United States. doi:10.1016/J.IJROBP.2016.01.013.
Armstrong, Carol L., E-mail: armstrongc@email.chop.edu, Fisher, Michael J., Li, Yimei, Lustig, Robert A., Belasco, Jean B., Minturn, Jane E., Hill-Kayser, Christine E., Batra, Sonny, and Phillips, Peter C. Fri . "Neuroplastic Response After Radiation Therapy for Pediatric Brain Tumors: A Pilot Study". United States. doi:10.1016/J.IJROBP.2016.01.013.
@article{osti_22648712,
title = {Neuroplastic Response After Radiation Therapy for Pediatric Brain Tumors: A Pilot Study},
author = {Armstrong, Carol L., E-mail: armstrongc@email.chop.edu and Fisher, Michael J. and Li, Yimei and Lustig, Robert A. and Belasco, Jean B. and Minturn, Jane E. and Hill-Kayser, Christine E. and Batra, Sonny and Phillips, Peter C.},
abstractNote = {Purpose: Clinically effective measurement of cognitive toxicity from photon radiation therapy (XRT) should be accurate, sensitive, and specific. This pilot study tested translational findings on phasic changes in children's memory systems that are sensitive and insensitive to toxic XRT effects to identify a possible neuroplastic effect. Methods and Materials: Memory processes were prospectively tested before XRT and at 3 later time points up to 2 years in 35 children with mixed primary brain tumors who had not experienced recurrence. Memory processes were verbal-semantic, visual-semantic, and visual-perceptual, including accuracy, speed to recall, encoding, retrieval, and recognition. The mixed-effects model included time (to estimate slope), covariates (age, tumor locus, XRT field, and medications) as fixed effects, and individual random intercepts. A sensitivity analysis examined the influence of XRT dose to the hippocampi on memory. Results: Retrieval from long-term verbal-semantic memory declined 2 months after completing XRT, as seen in adults, and was lowest at 1 year, which was delayed in comparison with adults. Double dissociation from visual-perceptual memory at baseline and 2 months was found, consistent with adults. Recovery was demonstrated 2 years after XRT. Patterns were unchanged when dose to hippocampus was included in the model. Conclusions: Verbal and semantic long-term retrieval is specifically sensitive to XRT-related cognitive dysfunction, without effect on visual-perceptual memory. Children reached nadir in XRT-sensitive memory 1 year after XRT and recovered by 2 years, which is later than that observed in adults. The protracted period of post-XRT injury may represent the maturation of the human hippocampus and white matter into late adolescence.},
doi = {10.1016/J.IJROBP.2016.01.013},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 3,
volume = 95,
place = {United States},
year = {Fri Jul 01 00:00:00 EDT 2016},
month = {Fri Jul 01 00:00:00 EDT 2016}
}