Guidelines for Complications of Cancer Treatment Vol VIII Part B

CONCLUSION: The results document a moderate level ofneuropsychological morbidity among children with braintumors before stereotactic radiation therapy, presumablyreferable to the tumor itself and the surgery. The extent to whichstereotactic radiation therapy may increase this burden willbe assessed in follow-up studies evaluating the longitudinalneuropsychological data.2. Predicting change in academic abilities afterconformal radiation therapy for localizedependymoma. Conklin HM, Li C, Xiong X, Ogg RJ,Merchant TE. J Clin Oncol.2008;26(24):3965-70PURPOSE: Conformal radiation therapy (CRT) aims to limitthe highest radiation dose to the tissue volume at risk whilesparing surrounding normal tissues. This study investigatedwhether treatment of childhood ependymoma with CRT wouldpreserve cognitive function. Academic competence was chosenas the primary outcome measure given it is a measure ofapplied cognitive abilities in a child’s natural setting.PATIENTS AND METHODS: Eighty-seven pediatric patientsdiagnosed with ependymoma received CRT in which dosesranging from 54.0 to 59.4 Gy were prescribed to thepostoperative tumor bed with a 10-mm clinical target volumemargin. Cognitive testing was conducted at the start of CRT, 6months, and annually after the start of CRT. The median lengthof follow-up was 59.6 months. Academic testing includedsubtests from the Wechsler Individual Achievement Test(WIAT) and the Achenbach Child Behavior Checklist.RESULTS: Linear mixed models with random coefficientsrevealed a modest but significant decline in reading scoresduring follow-up (WIAT slope estimate -0.064 +/- 0.028points/month; P = .026). Math and spelling performanceremained stable. Supratentorial tumor location and multiplesurgeries were predictive of worse reading performance at CRT356