Frontiers in Oncology (Aug 2017)

Relationships between Regional Radiation Doses and Cognitive Decline in Children Treated with Cranio-Spinal Irradiation for Posterior Fossa Tumors

  • Elodie Doger de Speville,
  • Elodie Doger de Speville,
  • Elodie Doger de Speville,
  • Charlotte Robert,
  • Charlotte Robert,
  • Charlotte Robert,
  • Charlotte Robert,
  • Martin Perez-Guevara,
  • Antoine Grigis,
  • Stephanie Bolle,
  • Clemence Pinaud,
  • Clemence Pinaud,
  • Christelle Dufour,
  • Anne Beaudré,
  • Anne Beaudré,
  • Virginie Kieffer,
  • Virginie Kieffer,
  • Audrey Longaud,
  • Audrey Longaud,
  • Jacques Grill,
  • Jacques Grill,
  • Dominique Valteau-Couanet,
  • Dominique Valteau-Couanet,
  • Eric Deutsch,
  • Eric Deutsch,
  • Eric Deutsch,
  • Eric Deutsch,
  • Dimitri Lefkopoulos,
  • Dimitri Lefkopoulos,
  • Catherine Chiron,
  • Catherine Chiron,
  • Lucie Hertz-Pannier,
  • Lucie Hertz-Pannier,
  • Marion Noulhiane,
  • Marion Noulhiane

DOI
https://doi.org/10.3389/fonc.2017.00166
Journal volume & issue
Vol. 7

Abstract

Read online

Pediatric posterior fossa tumor (PFT) survivors who have been treated with cranial radiation therapy often suffer from cognitive impairments that might relate to IQ decline. Radiotherapy (RT) distinctly affects brain regions involved in different cognitive functions. However, the relative contribution of regional irradiation to the different cognitive impairments still remains unclear. We investigated the relationships between the changes in different cognitive scores and radiation dose distribution in 30 children treated for a PFT. Our exploratory analysis was based on a principal component analysis (PCA) and an ordinary least square regression approach. The use of a PCA was an innovative way to cluster correlated irradiated regions due to similar radiation therapy protocols across patients. Our results suggest an association between working memory decline and a high dose (equivalent uniform dose, EUD) delivered to the orbitofrontal regions, whereas the decline of processing speed seemed more related to EUD in the temporal lobes and posterior fossa. To identify regional effects of RT on cognitive functions may help to propose a rehabilitation program adapted to the risk of cognitive impairment.

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