title: Long-term intellectual outcome in children with posterior fossa tumors according to radiation doses and volumes.
abstract: OBJECTIVE
  To analyze the relationship between craniospinal irradiation (CSI) and intellectual outcome in children with posterior fossa (PF) tumors.
  
  
  METHODS
  A neuropsychological evaluation was performed retrospectively in 31 children, aged 5-15 years, who had received radiotherapy for PF tumors, and who had been off therapy for at least 1 year. Factors evaluated for impact on intellectual outcome were: socioeconomic status, disease presentation, histology, complications, chemotherapy, age at radiotherapy, interval between radiotherapy and testing, and radiation doses and volumes. Patients were divided into 3 subgroups according to the CSI doses (0 Gy [i.e., PF irradiation only], 25 Gy, and 35 Gy), with 11, 11, and 9 patients, respectively.
  
  
  RESULTS
  Long-term cognitive impairment occurred in most of the patients, even after PF irradiation only. Moreover, there was a significant correlation between the full-scale IQ score (FSIQ) and the CSI dose, with mean FSIQ scores at 84.5 (SD = 14.0), 76.9 (SD = 16.6), and 63.7 (SD = 15.4) for 0 Gy, 25 Gy, and 35 Gy of CS1, respectively. A marked drop in verbal comprehension scores was noted in children who had received the higher dose.
  
  
  CONCLUSIONS
  This preliminary study further supports the rationale for de-escalation of CSI doses and volumes in standard-risk PF tumors.
authors.affiliation: Department of Pediatrics, Institut Gustave Roussy, Villejuif, France. jgrill@igr.fr
authors.forename: J
authors.initials: J
authors.lastname: Grill
authors.forename: V K
authors.initials: VK
authors.lastname: Renaux
authors.forename: C
authors.initials: C
authors.lastname: Bulteau
authors.forename: D
authors.initials: D
authors.lastname: Viguier
authors.forename: C
authors.initials: C
authors.lastname: Levy-Piebois
authors.forename: C
authors.initials: C
authors.lastname: Sainte-Rose
authors.forename: G
authors.initials: G
authors.lastname: Dellatolas
authors.forename: M A
authors.initials: MA
authors.lastname: Raquin
authors.forename: I
authors.initials: I
authors.lastname: Jambaqué
authors.forename: C
authors.initials: C
authors.lastname: Kalifa
mesh_terms: D000293:Adolescent; D002528:Cerebellar Neoplasms / Q000503:physiopathology / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D003071:Cognition / Q000528:radiation effects; D003388:Cranial Fossa, Posterior; D004522:Educational Status; D004806:Ependymoma / Q000503:physiopathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007360:Intelligence / Q000528:radiation effects*; D008297:Male; D008527:Medulloblastoma / Q000503:physiopathology / Q000532:radiotherapy*; D009483:Neuropsychological Tests; D011879:Radiotherapy Dosage; D012189:Retrospective Studies