A review of long-term deficits in memory systems following radiotherapy for pediatric posterior fossa tumor. (September 2022)

• Record Type: Journal Article
• Authors: Baudou, Eloïse; Pollidoro, Lisa; Iannuzzi, Stéphanie; Bertozzi, Anne-Isabelle; Tensaouti, Fatima; Chaix, Yves; Laprie, Anne
• Is Part Of: Radiotherapy and oncology. Volume 174(2022)
• Page Start: 111
• Page End: 122
• Publication Date: 2022-09
• Subjects: Posterior fossa tumors -- Neuropsychological outcomes -- Memory disorders -- Children -- Radiotherapy; CSI craniospinal irradiation -- IQ intellectual quotient -- PFB posteiror fossa boost -- PFT posterior fossa tumor -- SD standard deviation -- SRT serial reaction time -- TBB Tumor bed boost; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2022.05.022
• Languages: English
• ISSNs: 0167-8140

Abstract

Highlights: All memory systems are impaired in irradiated PFT survivors. Memory systems are more mildly affected in non-irradiated PFT survivors. Progress in radiotherapy has led to a reduction in long-term memory sequelae. Further investigation of procedural and episodic memory is warranted. Abstract: Introduction: In recent years, progress in pediatric posterior fossa tumor (PFT) treatments has improved survival rates. However, the majority of survivors present neurocognitive sequelae that impact academic achievement. Methods: This review examines the literature from 2000 to 2020 on long-term outcomes in different memory systems for survivors of pediatric PFT, considering the impact of radiotherapy which is a well-known prognostic factor for global neurocognitive function. Results: Of the 43 articles selected, 31 explored working memory, 19 episodic memory, 9 semantic memory and 2 procedural memory. Irradiated survivors had scores of <−2 standard deviation (SD) ( n = 4 studies/25) or between −2SD and −1SD ( n = 7 studies/25) for working memory; <−1SD for anterograde memory ( n = 11/13), with a progressive decline in these two memory systems; <−1SD ( n = 4/7) in semantic memory, and a deficit in perceptual-motor procedural learning ( n = 1/1). Reducing craniospinal irradiation dose, limiting tumor bed boosts, and using proton therapy seem to have had a beneficial effect with better preservation of the memory score and a reduction in the decline over time. Non-irradiated survivors had memory systems that were less affected, with preservation of anterograde memory and maintenance of long-term stability. Conclusion: Memory deficits are a core feature in survivors of pediatric PFT, especially when treatment requires radiotherapy. To limit these effects, dose constraints for specific brain areas involved in memory should be defined. During long-term follow-up, specific attention is essential to identify these deficits in order to limit their impact on the quality of life.