SynthesisWorld journal of pediatrics : WJP2023
Neurocognitive outcomes in pediatric brain tumors after treatment with proton versus photon radiation: a systematic review and meta-analysis.
Synthesis in World journal of pediatrics : WJP, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Effects of proton therapy on cognition in adults with brain tumors: a systematic review.Journal of neuro-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
- Non-cancer effects after proton beam therapy for pediatric tumors- a narrative review.Frontiers in oncology · 2025Pooled it
- Lithium for Radiation-Induced Damage in Pediatric Brain Tumors: Preclinical Evidence and Clinical Perspectives.Journal of clinical medicine · 2026Review
- Recurrent C19MC-altered embryonal tumors with multilayered rosettes: outcomes of stereotactic radiosurgery.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Health-Related Quality of Life in Children with Acute Leukaemia and Central Nervous System Tumours: Current Evidence and Future Directions.Children (Basel, Switzerland) · 2026Review
- Six-month evaluation of normal mouse brain side effects: Comparing FLASH and conventional proton partial brain irradiation.Clinical and translational radiation oncology · 2026Article
- Proton therapy in Spain: SEOR-SPROMP multidisciplinary recommendations developed through a RAND/UCLA consensus process.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Emerging Outcome Trends From Proton Therapy for Pediatric CNS Tumors: A Systematic Review.International journal of particle therapy · 2026Review
- Advances in proton therapy technology and global clinical applications.Frontiers in oncology · 2026Review
- Subcortical alterations following pediatric posterior fossa brain tumor treatment: A longitudinal MRI study.Neuroimage. Reports · 2025Article
- Neurocognitive and Emotional Outcomes in Childhood Cancer: A Developmental Perspective.Current oncology (Toronto, Ont.) · 2025Review
- Article
- Proton therapy for adult type IDH-mutated glioma: Proglio-1, a multicenter retrospective study.Radiation oncology (London, England) · 2025Article
- Neuropsychological outcome in pediatric brain tumor survivors treated with proton radiation prior to age 4 years.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Article
- Pediatric CNS Radiation Oncology: Recent Developments and Novel Techniques.Current oncology (Toronto, Ont.) · 2025Review
- Neurocognitive outcomes and functional independence in adult survivors of childhood medulloblastoma diagnosed over 3 decades.Neuro-oncology · 2025Article
- Role of global neurosurgery in tackling pediatric brain tumors: an insight.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Psychosocial and executive functioning late effects in pediatric brain tumor survivors after proton radiation.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 7 institutions in 3 countries.
Funding
Abstract
backgroundAdvances in cancer treatments, particularly the development of radiation therapy, have led to improvements in survival outcomes in children with brain tumors. However, radiation therapy is associated with significant long-term neurocognitive morbidity. The present systematic review and meta-analysis aimed to compare the neurocognitive outcomes of children and adolescents with brain tumors treated with photon radiation (XRT) or proton therapy (PBRT).
methodsA systematic search was conducted (PubMed, Embase, Cochrane, and Web of Science from inception until 02/01/2022) for studies comparing the neurocognitive outcomes of children and adolescents with brain tumors treated with XRT vs. PBRT. The pooled mean differences (expressed as Z scores) were calculated using a random effects method for those endpoints analyzed by a minimum of three studies.
resultsTotally 10 studies (n = 630 patients, average age range: 1-20 years) met the inclusion criteria. Patients who had received PBRT achieved significantly higher scores (difference in Z scores ranging from 0.29-0.75, all P < 0.05 and significant in sensitivity analyses) after treatment than those who had received XRT for most analyzed neurocognitive outcomes (i.e., intelligence quotient, verbal comprehension and perceptual reasoning indices, visual motor integration, and verbal memory). No robust significant differences (P > 0.05 in main analyses or sensitivity analyses) were found for nonverbal memory, verbal working memory and working memory index, processing speed index, or focused attention.
conclusionsPediatric brain tumor patients who receive PBRT achieve significantly higher scores on most neurocognitive outcomes than those who receive XRT. Larger studies with long-term follow-ups are needed to confirm these results.
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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.