Peer-reviewed article
QOL-20. IMPACT OF RADIATION DOSE AND VOLUME ON MEMORY FUNCTIONING IN CHILDREN WITH MEDULLOBLASTOMA: A REPORT FROM CHILDREN’S ONCOLOGY GROUP (COG) ACNS0331
Embry L, Colte P, Cullen P, Michalski J, Li Y et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This peer-reviewed study examines memory functioning in children treated for medulloblastoma, a type of brain cancer, using different radiation dose protocols. The research followed 354 children over six years after diagnosis, measuring their verbal and visual memory at three timepoints. The study found that younger children who received standard-dose radiation had higher rates of memory impairment compared to those who received lower doses. The authors conclude that reducing radiation dose or volume in young children with medulloblastoma may help preserve memory function.
Key points
- 43.4% of children showed impairment in verbal learning immediately after treatment and 40.7% after delay at the final measurement
- 58.6% of children receiving standard-dose CSI showed delayed verbal learning impairment compared to 34.8% receiving lower-dose CSI
- Mean age at diagnosis was 9.1 years, ranging from 3–19 years
- 354 of 464 enrolled patients (76%) completed neuropsychological testing across three timepoints over 6 years
- Younger children (aged 3-7) receiving standard radiation had particularly high rates of memory impairment
Limitations
This study focuses on cognitive side effects of cancer treatment in a specific disease population, not on general child well-being or health interventions. The research is primarily about documenting treatment toxicities in paediatric oncology rather than evaluating an intervention for a well-being problem.
Abstract
Abstract BACKGROUND/OBJECTIVES We examined longitudinal verbal and visual memory functioning in children treated for medulloblastoma on COG protocol ACNS0331. METHODS Children with medulloblastoma participated in neuropsychological testing at three timepoints over a 6-year period. Children aged 3–7 years were randomized to receive craniospinal irradiation (CSI) of either 23.4Gy (standard dose; SDCSI) or 18Gy (lower dose; LDCSI). Children aged 8+ received SDCSI. All children were also randomized to receive either a reduced radiation boost to the involved field (IFRT) or a standard boost to the whole posterior fossa (PFRT). Memory functioning was evaluated an average of 0.67(T1), 2.95(T2), and 4.90(T3) years post-diagnosis. RESULTS Of 464 eligible patients enrolled on ACNS0331, 354 (76%; 65.3% male, 83.1% white) completed some neuropsychological testing. Mean age at diagnosis was 9.1 years (range=3–19). Verbal and visual short-term memory and learning were broadly within the average range for the overall sample at all three timepoints. However, a large percentage of children exhibited scores ≥1SD below the mean on tasks of verbal learning both immediately (43.4%) and after a delay (40.7%) at T3. In addition, 58.6% of children randomized to SDCSI exhibited impairment in verbal learning after a delay compared to 34.8% of children randomized to LDSCI, and 35.0% of those aged ≥8 at diagnosis receiving SDCSI. CONCLUSIONS Younger children receiving SDCSI have particularly high rates of memory impairment five years after diagnosis of medulloblastoma. Limiting CSI dose and/or volume in young children treated for this diagnosis may improve outcomes for memory functioning.