Journal
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
Volume 92, Issue 5, Pages 978-985Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.ijrobp.2015.04.023
Keywords
-
Funding
- Brain Tumour Charity
- Children's Cancer and Leukaemia Group
- German Ministry of Health and Education [BMBF 01GI9958/5]
- European Union Seventh Framework Programme (FP7) under project European Network for Cancer Research in Children and Adolescents (ENCCA) [261743]
- German Children's Cancer Foundation (Deutsche Kinderkrebsstiftung), Fordergemeinschaft Kinderkrebszentrum Hamburg e.V.
- French Ministry of Health
- French National Cancer Institute
- Swedish Childhood Cancer Foundation
- Wessex Medical Research
- Cancer Research UK
- Piam Brown Charitable Fund Southampton
Ask authors/readers for more resources
Purpose: In the European HIT-SIOP PNET4 randomized controlled trial, children with standard risk medulloblastoma were allocated to hyperfractionated radiation therapy (HFRT arm, including a partially focused boost) or standard radiation therapy (STRT arm), followed, in both arms, by maintenance chemotherapy. Event-free survival was similar in both arms. Previous work showed that the HFRT arm was associated with worse growth and better questionnaire-based executive function, especially in children < 8 years of age at diagnosis. Therefore, the aim of this study was to compare performance-based cognitive outcomes between treatment arms. Methods and Materials: Neuropsychological data were collected prospectively in 137 patients. Using the Wechsler Intelligence Scales, Kaufman Assessment Battery for Children, and Raven's Progressive Matrices, we estimated full-scale intelligence quotient (FSIQ) and, when available, verbal IQ (VIQ), performance IQ (PIQ), working memory index (WMI), and processing speed index (PSI). Results: Among the 137 participants (HFRT arm n=71, STRT arm n=66, 63.5% males), mean (+/- SD) ages at diagnosis and assessment respectively were 9.3 (+/- 3.2) years of age (40.8% < 8 years of age at diagnosis) and 14.6 (+/- 4.3) years of age. Mean (+/- SD) FSIQ was 88 (+/- 19), and mean intergroup difference was 3.88 (95% confidence interval: -2.66 to 10.42, P = .24). No significant differences were found in children > 8 years of age at diagnosis. In children < 8 years of age at diagnosis, a marginally significant trend toward higher VIQ was found in those treated in the HFRT arm; a similar trend was found for PSI but not for PIQ, WMI, or FSIQ (mean intergroup differences were: 12.02 for VIQ [95% CI: 2.37-21.67; P=.02]; 3.77 for PIQ [95% CI: -5.19 to 12.74; P>.10]; 5.20 for WMI [95% CI: -2.07 to 12.47; P>.10]; 10.90 for PSI [95% CI: -1.54 to 23.36; P=.08]; and 5.28 for FSIQ [95% CI: -4.23 to 14.79; P>.10]). Conclusions: HFRT was associated with marginally higher VIQ in children < 8 years of age at diagnosis, consistent with a previous report using questionnaire- based data. However, overall cognitive ability was not significantly different. (C) 2015 Elsevier Inc. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available