Region-specific radiotherapy and neuropsychological outcomes in adult survivors of childhood CNS malignancies

Gregory Armstrong, Neelam Jain, Wei Liu, Thomas E. Merchant, Marilyn Stovall, Deo Kumar Srivastava, James G. Gurney, Roger J. Packer, Leslie L. Robison, Kevin R. Krull

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Childhood cancer survivors exposed to CNS irradiation are at increased risk for neurocognitive deficits; however, limited data exist linking outcomes with region-specific exposure to CNS irradiation. We report associations between region-specific radiation dose and self-reported neurocognitive and health-related quality of life (HRQOL) outcomes in 818 adult survivors of childhood central nervous system (CNS) malignancies from the Childhood Cancer Survivor Study. Survivors were compared with a sibling group and national normative samples to calculate standardized scores. Cumulative radiation dose was calculated for 4 specific brain regions. Logistic regression was used to estimate the association between radiation dose to specific brain regions and outcome measures of functional impairment adjusted for clinical and demographic factors, including sex and age at diagnosis. High radiation dose levels to temporal regions were associated with a higher risk for memory impairment (radiation doses ≥30 to <50 Gy: OR, 1.95; 95% CI, 1.01-3.78; dose ≥50 Gy: OR, 2.34; 95% CI, 1.25-4.39) compared with those with no radiation exposure. No such association was seen with radiation exposure to other regions. Exposure to temporal regions was associated with more social and general health problems, whereas exposure to frontal regions was associated with general health problems and physical performance limitations. Adult survivors of childhood CNS malignancies report higher rates of neuropsychological and HRQOL outcomes, which vary as a function of dose to specific neuroanatomical regions. Survivors with a history of radiation exposure to temporal brain regions are at increased risk for impairment in memory and social functioning.

Original languageEnglish (US)
Pages (from-to)1173-1186
Number of pages14
JournalNeuro-Oncology
Volume12
Issue number11
DOIs
StatePublished - Nov 1 2010
Externally publishedYes

Fingerprint

Survivors
Radiotherapy
Central Nervous System
Radiation
Temporal Lobe
Neoplasms
Brain
Quality of Life
Health
Siblings
Logistic Models
Demography
Outcome Assessment (Health Care)
Radiation Exposure

All Science Journal Classification (ASJC) codes

  • Oncology
  • Clinical Neurology
  • Cancer Research

Cite this

Armstrong, G., Jain, N., Liu, W., Merchant, T. E., Stovall, M., Srivastava, D. K., ... Krull, K. R. (2010). Region-specific radiotherapy and neuropsychological outcomes in adult survivors of childhood CNS malignancies. Neuro-Oncology, 12(11), 1173-1186. https://doi.org/10.1093/neuonc/noq104

Region-specific radiotherapy and neuropsychological outcomes in adult survivors of childhood CNS malignancies. / Armstrong, Gregory; Jain, Neelam; Liu, Wei; Merchant, Thomas E.; Stovall, Marilyn; Srivastava, Deo Kumar; Gurney, James G.; Packer, Roger J.; Robison, Leslie L.; Krull, Kevin R.

In: Neuro-Oncology, Vol. 12, No. 11, 01.11.2010, p. 1173-1186.

Research output: Contribution to journalArticle

Armstrong, G, Jain, N, Liu, W, Merchant, TE, Stovall, M, Srivastava, DK, Gurney, JG, Packer, RJ, Robison, LL & Krull, KR 2010, 'Region-specific radiotherapy and neuropsychological outcomes in adult survivors of childhood CNS malignancies', Neuro-Oncology, vol. 12, no. 11, pp. 1173-1186. https://doi.org/10.1093/neuonc/noq104
Armstrong, Gregory ; Jain, Neelam ; Liu, Wei ; Merchant, Thomas E. ; Stovall, Marilyn ; Srivastava, Deo Kumar ; Gurney, James G. ; Packer, Roger J. ; Robison, Leslie L. ; Krull, Kevin R. / Region-specific radiotherapy and neuropsychological outcomes in adult survivors of childhood CNS malignancies. In: Neuro-Oncology. 2010 ; Vol. 12, No. 11. pp. 1173-1186.
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