ArticlePediatric blood & cancer2021
Long-term cognitive and academic outcomes among pediatric brain tumor survivors treated with proton versus photon radiotherapy.
Article in Pediatric blood & cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 5 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Non-cancer effects after proton beam therapy for pediatric tumors- a narrative review.Frontiers in oncology · 2025Pooled it
- Pooled it
- Long-term neurocognitive and behavioral outcomes in survivors of pediatric brain tumors: a systematic review.Frontiers in neuroscience · 2025Pooled it
- Neurocognitive outcomes in pediatric brain tumors after treatment with proton versus photon radiation: a systematic review and meta-analysis.World journal of pediatrics : WJP · 2023Pooled it
- Influences on cognitive outcomes in adult patients with gliomas: A systematic review.Frontiers in oncology · 2022Pooled it
- Emerging Outcome Trends From Proton Therapy for Pediatric CNS Tumors: A Systematic Review.International journal of particle therapy · 2026Review
- Epidemiology of brain and central nervous system cancers in children and adolescents.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Management of late toxicities and specific follow-up needs of adolescent and young adult cancer survivors: recommendations from scientific societies in Spain.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Proton versus photon radiotherapy in adults with primary brain tumors evaluating functional survival: a phase 3 randomized controlled trial study protocol (PRIDE).Radiation oncology (London, England) · 2026Article
- Developmental Foundations of Psychosocial Interventions in Pediatric Oncology: A Lifespan Framework for Resilience.Children (Basel, Switzerland) · 2026Review
- The utility of long-term methylphenidate in preserving intellectual development in survivors of childhood brain tumour.Journal of neuro-oncology · 2025Article
- Neurocognitive and Emotional Outcomes in Childhood Cancer: A Developmental Perspective.Current oncology (Toronto, Ont.) · 2025Review
- Prospective analysis on possible changes of cognitive functions in children on follow-up for brain tumor.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Article
- Academic readiness among young children treated for brain tumors: a multisite, prospective, longitudinal trial.Journal of the National Cancer Institute · 2024Article
- The impact of the titanium cranial hardware in proton single-field uniform dose plans.Journal of applied clinical medical physics · 2024Article
- Approaches to Minimise the Neurodevelopmental Impact of Choroid Plexus Carcinoma and Its Treatment.Life (Basel, Switzerland) · 2023Review
- Longitudinal health-related quality of life analysis in childhood cancer survivors after proton beam therapy.International journal of clinical oncology · 2023Article
- Comparison of neurocognitive and quality-of-life outcomes in pediatric craniopharyngioma patients treated with partial resection and radiotherapy versus gross-total resection only.Journal of neurosurgery. Pediatrics · 2023Article
- Investigating survival, quality of life and cognition in PROton versus photon therapy forBMJ open · 2023Article
- Article
Corrections and comments
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Authors and funding
15 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundProton radiotherapy (PRT) may be associated with less neurocognitive risk than photon RT (XRT) for pediatric brain tumor survivors. We compared neurocognitive and academic outcomes in long-term survivors treated with XRT versus PRT.
methodsSurvivors underwent neurocognitive evaluation >1 year after craniospinal (CSI) or focal PRT or XRT. Groups were compared using separate one-way analyses of covariance for the CSI and focal groups.
resultsPRT (n = 58) and XRT (n = 30) subgroups were similar on gender (66% male), age at RT (median = 6.5 years), age at follow-up (median = 14.6 years), and government assistance status (32%). PRT and XRT focal groups differed on follow-up interval, shunt history, and total RT dose (all p < .05), whereas PRT and XRT CSI groups differed on follow-up interval, baseline neurocognitive performance score, boost volume, and CSI dose (all p < .05). The PRT focal group outperformed the XRT focal group on inhibition/switching (p = .04). The PRT CSI group outperformed the XRT CSI group on inattention/impulsivity (both p < .05). Several clinical variables (i.e., RT dose, boost field, baseline performance) predicted neurocognitive outcomes (all p < .05). The PRT focal group performed comparably to population means on most neurocognitive measures, while both CSI groups performed below expectation on multiple measures. The XRT CSI group was most impaired. All groups fell below expectation on processing speed, fine motor, and academic fluency (most p < .01).
conclusionsFindings suggest generally favorable neurocognitive and academic long-term outcomes following focal PRT. Impairment was greatest following CSI regardless of modality. Dosimetry and baseline characteristics are important determinants of outcome alone or in combination with modality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.