title: A prospective study of cerebral, frontal lobe, and temporal lobe volumes and neuropsychological performance in children with primary brain tumors treated with cranial radiation.
abstract: BACKGROUND
  Cranial radiation therapy (RT) is an important component in the treatment of pediatric brain tumors. However, it can result in long-term effects on the developing brain. This prospective study assessed the effects of cranial RT on cerebral, frontal lobe, and temporal lobe volumes and their correlation with higher cognitive functioning.
  
  
  METHODS
  Ten pediatric patients with primary brain tumors treated with cranial RT and 14 age- and sex-matched healthy children serving as controls were evaluated. Quantitative magnetic resonance imaging and neuropsychological assessments (language, memory, auditory and visual processing, and vocabulary) were performed at the baseline and 6, 15, and 27 months after RT. The effects of age, the time since RT, and the cerebral RT dose on brain volumes and neuropsychological performance were analyzed with linear mixed effects model analyses.
  
  
  RESULTS
  Cerebral volume increased significantly with age in both groups (P = .01); this increase in volume was more pronounced in younger children. Vocabulary performance was found to be significantly associated with a greater cerebral volume (P = .05) and a lower RT dose (P = .003). No relation was observed between the RT dose and the cerebral volume. There was no difference in the corresponding neuropsychological tests between the 2 groups.
  
  
  CONCLUSIONS
  This prospective study found significant relations among the RT dose, cerebral volumes, and rate of vocabulary development among children receiving RT. The results of this study provide further support for clinical trials aimed at reducing cranial RT doses in the pediatric population. Cancer 2017;161-168. © 2016 American Cancer Society.
authors: Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Harold
authors: H
authors: Agbahiwe
authors: Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.|University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors: Arif
authors: A
authors: Rashid
authors: Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Alena
authors: A
authors: Horska
authors: Department of Neuropsychology, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.|Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: E Mark
authors: EM
authors: Mahone
authors: Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Doris
authors: D
authors: Lin
authors: Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Todd
authors: T
authors: McNutt
authors: Division of Pediatric Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Kenneth
authors: K
authors: Cohen
authors: Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Kristin
authors: K
authors: Redmond
authors: Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Moody
authors: M
authors: Wharam
authors: Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Stephanie
authors: S
authors: Terezakis
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000503:physiopathology* / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D003071:Cognition / Q000528:radiation effects; D016371:Cranial Irradiation / Q000009:adverse effects*; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology* / Q000528:radiation effects*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008568:Memory / Q000528:radiation effects; D009483:Neuropsychological Tests; D011446:Prospective Studies; D013702:Temporal Lobe / Q000503:physiopathology* / Q000528:radiation effects*
keywords: central nervous system (CNS) tumors; longitudinal outcomes; neurocognitive side effects of radiation therapy; pediatric radiation oncology; volumetric magnetic resonance imaging (MRI)