Superior Verbal Learning and Memory in Pediatric Brain Tumor Survivors Treated With Proton Versus Photon Radiotherapy

Authors

Lisa E Mash
Lisa S Kahalley
M Fatih Okcu
David R Grosshans
Arnold C Paulino
Heather Stancel
Luz De Leon
Elisabeth Wilde
Nilesh Desai
Zili D Chu
William E Whitehead
Murali Chintagumpala
Kimberly P Raghubar

Publication Date

2-1-2023

Journal

Neuropsychology

Abstract

OBJECTIVE: Radiotherapy for pediatric brain tumor has been associated with late cognitive effects. Compared to conventional photon radiotherapy (XRT), proton radiotherapy (PRT) delivers lower doses of radiation to healthy brain tissue. PRT has been associated with improved long-term cognitive outcomes compared to XRT. However, there is limited research comparing the effects of XRT and PRT on verbal memory.

METHOD: Survivors of pediatric brain tumor treated with either XRT (

RESULTS: Overall, patients receiving PRT demonstrated superior verbal learning and recall compared to those treated with XRT. Encoding and retrieval deficits were more common in the XRT group than the PRT group, with encoding problems being most prevalent. The PRT group was more likely to engage in semantic clustering strategies, which predicted better encoding and retrieval. Encoding ability was associated with higher intellectual and adaptive functioning, and fewer parent-reported concerns about day-to-day attention and cognitive regulation.

CONCLUSION: Results suggest that PRT is associated with verbal memory sparing, driven by effective encoding and use of learning strategies. Future work may help to clarify underlying neural mechanisms associated with verbal memory decline, which will better inform treatment approaches.

Keywords

Pediatric brain tumor, proton radiotherapy, verbal memory, late effects

Comments

PMID: 36480379