Raymond B Mailhot Vega, Daniel J Indelicato, Julie A Bradley, Erin M Mobley, Emma Viviers, Christopher G Morris, Adeel Markatia, Yousef Ramahi, Christine F Delgado, Carla L Fisher, Nancy P Mendenhall, Kimberly P Raghubar, Amy M Crisp, M David Miller
{"title":"接受放射治疗的儿童脑肿瘤幸存者脑亚结构剂量与学习成绩的关系。","authors":"Raymond B Mailhot Vega, Daniel J Indelicato, Julie A Bradley, Erin M Mobley, Emma Viviers, Christopher G Morris, Adeel Markatia, Yousef Ramahi, Christine F Delgado, Carla L Fisher, Nancy P Mendenhall, Kimberly P Raghubar, Amy M Crisp, M David Miller","doi":"10.1016/j.ijrobp.2025.07.1418","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Radiotherapy may cause cognitive deficits in pediatric brain tumor survivors (PBTS). Scholastic data provides pre-diagnostic measurements, is practical for patients and families, and aligns with student learning before and after treatment. We evaluated the association between radiation dose to organs at risk (OARs) and scholastic achievement in PBTS.</p><p><strong>Materials/methods: </strong>With IRB approval, we retrospectively analyzed scholastic achievement in PBTS treated with radiation from 2007-2021 at our institution. The state's Department of Education (DOE) provided scholastic data, merged with institutional clinical data. DOE also provided scholastic data on healthy children matched 3:1. A general linear mixed-effects model was performed with scholastic dependent variables from the post-treatment phase and the independent variable of mean OAR dose to the hippocampus, corpus callosum (CC), and frontal lobe (FL). Sensitivity analysis was conducted, limited to only children in the treatment group. Exploratory analyses evaluating volumetric associations between OARs and scholastic outcomes were conducted.</p><p><strong>Results: </strong>Fifty PBTS and 150 matched controls were included with a median age of 11.6 years at treatment and 7 years of follow-up. In the primary model, increasing mean dose to the hippocampus (p = 0.048), CC (p = 0.053), and FL (p = 0.097) were negatively associated with standard grade promotion. In the secondary model restricted to PBTS, only hippocampal dose remained significantly associated with grade promotion (p = 0.092). Volumetric analyses determined negative associations between higher V5-V20 to the hippocampus and FL and Mathematics and higher V25-V40 to the FL and Reading.</p><p><strong>Conclusions: </strong>We present the first ever report evaluating associations between dosimetry and scholastic performance. We demonstrate a novel method using scholastic performance data as a patient-centered metric, leveraging prospectively state-collected scholastic outcomes.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5000,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association between brain substructure dose and scholastic performance in pediatric brain tumor survivors who received radiotherapy.\",\"authors\":\"Raymond B Mailhot Vega, Daniel J Indelicato, Julie A Bradley, Erin M Mobley, Emma Viviers, Christopher G Morris, Adeel Markatia, Yousef Ramahi, Christine F Delgado, Carla L Fisher, Nancy P Mendenhall, Kimberly P Raghubar, Amy M Crisp, M David Miller\",\"doi\":\"10.1016/j.ijrobp.2025.07.1418\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Radiotherapy may cause cognitive deficits in pediatric brain tumor survivors (PBTS). 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Exploratory analyses evaluating volumetric associations between OARs and scholastic outcomes were conducted.</p><p><strong>Results: </strong>Fifty PBTS and 150 matched controls were included with a median age of 11.6 years at treatment and 7 years of follow-up. In the primary model, increasing mean dose to the hippocampus (p = 0.048), CC (p = 0.053), and FL (p = 0.097) were negatively associated with standard grade promotion. In the secondary model restricted to PBTS, only hippocampal dose remained significantly associated with grade promotion (p = 0.092). Volumetric analyses determined negative associations between higher V5-V20 to the hippocampus and FL and Mathematics and higher V25-V40 to the FL and Reading.</p><p><strong>Conclusions: </strong>We present the first ever report evaluating associations between dosimetry and scholastic performance. We demonstrate a novel method using scholastic performance data as a patient-centered metric, leveraging prospectively state-collected scholastic outcomes.</p>\",\"PeriodicalId\":14215,\"journal\":{\"name\":\"International Journal of Radiation Oncology Biology Physics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.5000,\"publicationDate\":\"2025-07-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Radiation Oncology Biology Physics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ijrobp.2025.07.1418\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Radiation Oncology Biology Physics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ijrobp.2025.07.1418","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
Association between brain substructure dose and scholastic performance in pediatric brain tumor survivors who received radiotherapy.
Purpose: Radiotherapy may cause cognitive deficits in pediatric brain tumor survivors (PBTS). Scholastic data provides pre-diagnostic measurements, is practical for patients and families, and aligns with student learning before and after treatment. We evaluated the association between radiation dose to organs at risk (OARs) and scholastic achievement in PBTS.
Materials/methods: With IRB approval, we retrospectively analyzed scholastic achievement in PBTS treated with radiation from 2007-2021 at our institution. The state's Department of Education (DOE) provided scholastic data, merged with institutional clinical data. DOE also provided scholastic data on healthy children matched 3:1. A general linear mixed-effects model was performed with scholastic dependent variables from the post-treatment phase and the independent variable of mean OAR dose to the hippocampus, corpus callosum (CC), and frontal lobe (FL). Sensitivity analysis was conducted, limited to only children in the treatment group. Exploratory analyses evaluating volumetric associations between OARs and scholastic outcomes were conducted.
Results: Fifty PBTS and 150 matched controls were included with a median age of 11.6 years at treatment and 7 years of follow-up. In the primary model, increasing mean dose to the hippocampus (p = 0.048), CC (p = 0.053), and FL (p = 0.097) were negatively associated with standard grade promotion. In the secondary model restricted to PBTS, only hippocampal dose remained significantly associated with grade promotion (p = 0.092). Volumetric analyses determined negative associations between higher V5-V20 to the hippocampus and FL and Mathematics and higher V25-V40 to the FL and Reading.
Conclusions: We present the first ever report evaluating associations between dosimetry and scholastic performance. We demonstrate a novel method using scholastic performance data as a patient-centered metric, leveraging prospectively state-collected scholastic outcomes.
期刊介绍:
International Journal of Radiation Oncology • Biology • Physics (IJROBP), known in the field as the Red Journal, publishes original laboratory and clinical investigations related to radiation oncology, radiation biology, medical physics, and both education and health policy as it relates to the field.
This journal has a particular interest in original contributions of the following types: prospective clinical trials, outcomes research, and large database interrogation. In addition, it seeks reports of high-impact innovations in single or combined modality treatment, tumor sensitization, normal tissue protection (including both precision avoidance and pharmacologic means), brachytherapy, particle irradiation, and cancer imaging. Technical advances related to dosimetry and conformal radiation treatment planning are of interest, as are basic science studies investigating tumor physiology and the molecular biology underlying cancer and normal tissue radiation response.