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Neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk?

BACKGROUND: Children with brain tumors are at high risk of neurocognitive decline after radiotherapy (RT). However, there is a lack of studies on how RT doses to organs at risk (OARs) impacts neurocognition. The aim of this study was to examine dose-risk relationships for mean RT dose to different b...

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Autores principales: Söderström, Helena, Walfridsson, Angelica, Martinsson, Ulla, Isacsson, Ulf, Brocki, Karin, Kleberg, Johan Lundin, Ljungman, Gustaf
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416465/
https://www.ncbi.nlm.nih.gov/pubmed/37568180
http://dx.doi.org/10.1186/s13014-023-02324-2
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author Söderström, Helena
Walfridsson, Angelica
Martinsson, Ulla
Isacsson, Ulf
Brocki, Karin
Kleberg, Johan Lundin
Ljungman, Gustaf
author_facet Söderström, Helena
Walfridsson, Angelica
Martinsson, Ulla
Isacsson, Ulf
Brocki, Karin
Kleberg, Johan Lundin
Ljungman, Gustaf
author_sort Söderström, Helena
collection PubMed
description BACKGROUND: Children with brain tumors are at high risk of neurocognitive decline after radiotherapy (RT). However, there is a lack of studies on how RT doses to organs at risk (OARs) impacts neurocognition. The aim of this study was to examine dose-risk relationships for mean RT dose to different brain structures important for neurocognitive networks. We explored previously established OARs and potentially new OARs. METHODS: A sample of 44 pediatric brain tumor survivors who had received proton and/or photon RT were included. Correlations between mean RT doses to OARs and IQ were analyzed. Previously established OARs were cochleae, optic chiasm, optic nerve, pituitary gland, hypothalamus, hippocampus and pons. Potential new OARs for RT-induced neurocognitive decline were cerebellum, vermis and thalamus. RESULTS: Mean RT dose to different OARs correlated with several IQ subtests. Higher mean RT dose to cochleae, optic nerve, cerebellum, vermis and pons was correlated with lower performance on particularly full-scale IQ (FIQ), Perceptual Reasoning (PRI), Working Memory (WMI) and Processing Speed Index (PSI). Higher mean RT dose to hippocampus correlated with lower performance on processing speed and working memory. For those receiving whole brain RT (WBRT), higher mean RT dose to the pituitary gland correlated with lower performance on working memory. CONCLUSION: A high dose-risk correlation was found between IQ subtests and mean RT dose in established and potential new OARs. Thus, in the lack of validated dose constraints for vulnerable brain structures, a parsimonious approach in RT planning should be considered to preserve neurocognitive networks. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13014-023-02324-2.
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spelling pubmed-104164652023-08-12 Neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk? Söderström, Helena Walfridsson, Angelica Martinsson, Ulla Isacsson, Ulf Brocki, Karin Kleberg, Johan Lundin Ljungman, Gustaf Radiat Oncol Research BACKGROUND: Children with brain tumors are at high risk of neurocognitive decline after radiotherapy (RT). However, there is a lack of studies on how RT doses to organs at risk (OARs) impacts neurocognition. The aim of this study was to examine dose-risk relationships for mean RT dose to different brain structures important for neurocognitive networks. We explored previously established OARs and potentially new OARs. METHODS: A sample of 44 pediatric brain tumor survivors who had received proton and/or photon RT were included. Correlations between mean RT doses to OARs and IQ were analyzed. Previously established OARs were cochleae, optic chiasm, optic nerve, pituitary gland, hypothalamus, hippocampus and pons. Potential new OARs for RT-induced neurocognitive decline were cerebellum, vermis and thalamus. RESULTS: Mean RT dose to different OARs correlated with several IQ subtests. Higher mean RT dose to cochleae, optic nerve, cerebellum, vermis and pons was correlated with lower performance on particularly full-scale IQ (FIQ), Perceptual Reasoning (PRI), Working Memory (WMI) and Processing Speed Index (PSI). Higher mean RT dose to hippocampus correlated with lower performance on processing speed and working memory. For those receiving whole brain RT (WBRT), higher mean RT dose to the pituitary gland correlated with lower performance on working memory. CONCLUSION: A high dose-risk correlation was found between IQ subtests and mean RT dose in established and potential new OARs. Thus, in the lack of validated dose constraints for vulnerable brain structures, a parsimonious approach in RT planning should be considered to preserve neurocognitive networks. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13014-023-02324-2. BioMed Central 2023-08-11 /pmc/articles/PMC10416465/ /pubmed/37568180 http://dx.doi.org/10.1186/s13014-023-02324-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Söderström, Helena
Walfridsson, Angelica
Martinsson, Ulla
Isacsson, Ulf
Brocki, Karin
Kleberg, Johan Lundin
Ljungman, Gustaf
Neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk?
title Neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk?
title_full Neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk?
title_fullStr Neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk?
title_full_unstemmed Neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk?
title_short Neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk?
title_sort neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk?
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416465/
https://www.ncbi.nlm.nih.gov/pubmed/37568180
http://dx.doi.org/10.1186/s13014-023-02324-2
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