ArticlePediatric blood & cancer2020
Cognitive mediators of adaptive functioning outcomes in survivors of pediatric brain tumors treated with proton radiotherapy.
Article in Pediatric blood & cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Long-term neurocognitive and behavioral outcomes in survivors of pediatric brain tumors: a systematic review.Frontiers in neuroscience · 2025Pooled it
- Neurocognitive impairment following proton therapy for paediatric brain tumour: a systematic review of post-therapy assessments.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Pooled it
- Proton therapy and limited surgery for paediatric and adolescent patients with craniopharyngioma (RT2CR): a single-arm, phase 2 study.The Lancet. Oncology · 2023Trial
- Emerging Outcome Trends From Proton Therapy for Pediatric CNS Tumors: A Systematic Review.International journal of particle therapy · 2026Review
- Treatment Priorities in Craniopharyngioma: Perspectives of Survivors and Caregivers.Biomedicines · 2026Article
- Article
- Superior verbal learning and memory in pediatric brain tumor survivors treated with proton versus photon radiotherapy.Neuropsychology · 2023Article
- Article
- Cognitive Risk in Survivors of Pediatric Brain Tumors.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021Review
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundCranial radiotherapy (RT) is associated with risk for cognitive and adaptive dysfunction. Proton RT (PRT) is a technique hypothesized to spare cognition by reducing exposure to nontarget brain tissue. However, little is known regarding functional outcomes in survivors of pediatric brain tumor (BT) treated with PRT. The present study examined the relationship between cognitive and adaptive outcomes in pediatric BT survivors post-PRT.
methodsSurvivors treated with either focal (n = 33) or craniospinal irradiation (CSI; n = 37) PRT completed neurocognitive evaluations approximately 5 years post-treatment. Results of intelligence testing and ratings of adaptive functioning are reported. Mediation models examined the relationship among radiation field, cognition, and adaptive functioning.
resultsThe PRT CSI group demonstrated worse cognitive outcomes than the PRT Focal group across each cognitive index (Cohen's d = 0.56-0.70). Parent ratings of adaptive functioning were also worse in the PRT CSI group than the PRT Focal group (Global Adaptive Composite, d = 0.53; conceptual skills, d = 0.67). Cognitive performance fully mediated the relationship between radiation field and adaptive outcomes, while controlling for group differences in tumor histology and RT dose.
conclusionsFocal PRT survivors demonstrated generally positive outcomes with weaknesses in processing speed and aspects of adaptive functioning. CSI exposure was associated with more consistently poor cognitive and adaptive outcomes. The increased risk for adaptive dysfunction in the PRT CSI group appeared due to the effects of CSI on cognition. Efforts to reduce the volume of tissue exposure to RT remain important.
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