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Children with brain tumours may experience mental decline after radiation therapy.
S. Tsang of the Department of Radiology at Princess Margaret Cancer Center in Toronto, Canada, and others studied the response and cognitive changes to radiation therapy in different brain structure regions, the results of which were published online September 2020 in Neuro-Oncology.
study The authors analyzed data on 69 cases of brain tumors between 2005 and 2017.
56 of the 69 children who received radiation therapy.
children with longitudinal neuropsychological assessment data, and children receiving radiotherapy had photon dose measurement data.
provides forward-looking neuropsychiastic monitoring for children, and psychological tests are performed every 2 years, including full-scale IQ (FSIQ) assessment and perception reasoning (PRI), processing speed (PSI), speech understanding (VCI), and working memory (WMI) scores.
used a multivariate linear mixed effect model to simulate the endpoint, with the age of radiotherapy and the dose of different brain regions as fixed effects and specific random interception values for children.
P values are adjusted by multivariable statistical analysis.
study showed that the children with neuropsycological follow-up had a medium time of 3.2 years.
median dose of radiotherapy was 55.8Gy and the median dose of cerebrospinal cord exposure was 23.4Gy.
researchers found that the average dose of the right temporal lobe was closely related to a decrease in total IQ (p-0.005), a 50% dose of on-screen brain tissue (D50) was associated with a decrease in processing speed (p-0.006) and working memory (p-0.001), and a 50% dose of the left and right-hand hema was associated with speech understanding (p=0.009), respectively.
celiac semen servicing reduced FSIQ by 10 points.
conclusions The researchers believe that the above brain structure should be routinely divided or adjusted in doses in radiation therapy programs for children with brain tumors.
efforts to reduce the dose of exposure to fragile brain structures to reduce the risk of long-term neurocognitive changes after radiotherapy.
results are important for neuro-oncologists, radiation oncologists and neuropsychologists, and can guide clinicians in developing safe and effective radiotherapy programs.
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