RT journal article
T1 Neurocognitive outcomes in pediatric brain tumors after treatment with proton versus photon radiation: a systematic review and meta-analysis
A1 Lassaletta, Álvaro
A1 Morales Rojas, JavierSalvador
A1 Valenzuela, Pedro L.
A1 Esteso, Borja
A1 Kahalley, Lisa S.
A1 Mabbott, Donald J.
A1 Unnikrishnan, Soumya
A1 Panizo, Elena
A1 Calvo, Felipe
A2 Didáctica de la Educación FísicaPlástica y Musical
K1 Brain health
K1 Childhood cancer
K1 Intelligence quotient
K1 Radiotherapy
AB Background: Advances in cancer treatments, particularly the development of radiation therapy, have led to improvements in survival outcomes in children with brain tumors. However, radiation therapy is associated with significant long-term neurocognitive morbidity. The present systematic review and meta-analysis aimed to compare the neurocognitive outcomes of children and adolescents with brain tumors treated with photon radiation (XRT) or proton therapy (PBRT). Methods: A systematic search was conducted (PubMed, Embase, Cochrane, and Web of Science from inception until 02/01/2022) for studies comparing the neurocognitive outcomes of children and adolescents with brain tumors treated with XRT vs. PBRT. The pooled mean differences (expressed as Z scores) were calculated using a random effects method for those endpoints analyzed by a minimum of three studies. Results: Totally 10 studies (n = 630 patients, average age range: 1–20 years) met the inclusion criteria. Patients who had received PBRT achieved significantly higher scores (difference in Z scores ranging from 0.29–0.75, all P < 0.05 and significant in sensitivity analyses) after treatment than those who had received XRT for most analyzed neurocognitive outcomes (i.e., intelligence quotient, verbal comprehension and perceptual reasoning indices, visual motor integration, and verbal memory). No robust significant differences (P > 0.05 in main analyses or sensitivity analyses) were found for nonverbal memory, verbal working memory and working memory index, processing speed index, or focused attention. Conclusions: Pediatric brain tumor patients who receive PBRT achieve significantly higher scores on most neurocognitive outcomes than those who receive XRT. Larger studies with long-term follow-ups are needed to confirm these results.
PB Springer
SN 1708-8569
YR 2023
FD 2023-05-08
LK http://hdl.handle.net/10498/29394
UL http://hdl.handle.net/10498/29394
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 10-nov-2026