Attention, processing speed, and executive functioning in pediatric brain tumor survivors treated with proton beam radiation therapy

• Published in: Radiotherapy and oncology Vol. 124; no. 1; pp. 89 - 97
• Main Authors: Antonini, Tanya N., Ris, M. Douglas, Grosshans, David R., Mahajan, Anita, Okcu, M. Fatih, Chintagumpala, Murali, Paulino, Arnold, Child, Amanda E., Orobio, Jessica, Stancel, Heather H., Kahalley, Lisa S.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.07.2017
• Subjects: Adolescent; Attention - radiation effects; Brain Neoplasms - physiopathology; Brain Neoplasms - psychology; Brain Neoplasms - radiotherapy; Cancer Survivors - psychology; Child; Cognition Disorders - etiology; Cognitive late effects; Executive Function - radiation effects; Executive functioning; Female; Humans; Male; Neuropsychological Tests; Pediatric brain tumor; Processing speed; Proton radiation therapy; Proton Therapy - adverse effects; Proton Therapy - methods; Radiation Injuries - etiology; Risk Factors; Proton radiation therapy; Processing speed; Cognitive late effects; Pediatric brain tumor; Executive functioning
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2017.06.010

This study examines attention, processing speed, and executive functioning in pediatric brain tumor survivors treated with proton beam radiation therapy (PBRT). We examined 39 survivors (age 6–19years) who were 3.61years post-PBRT on average. Craniospinal (CSI; n=21) and focal (n=18) subgroups were analyzed. Attention, processing speed, and executive functioning scores were compared to population norms, and clinical/demographic risk factors were examined. As a group, survivors treated with focal PBRT exhibited attention, processing speed, and executive functioning that did not differ from population norms (all p>0.05). Performance in the CSI group across attention scales was normative (all p>0.05), but areas of relative weakness were identified on one executive functioning subtest and several processing speed subtests (all p<0.01). Survivors treated with PBRT may exhibit relative resilience in cognitive domains traditionally associated with radiation late effects. Attention, processing speed, and executive functioning remained intact and within normal limits for survivors treated with focal PBRT. Among survivors treated with CSI, a score pattern emerged that was suggestive of difficulties in underlying component skills (i.e., processing speed) rather than true executive dysfunction. No evidence of profound cognitive impairment was found in either group.