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Neurocognitive outcomes in pediatric brain tumors after treatment with proton versus photon radiation:a systematic review and meta-analysis

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世界儿科杂志:英文版 2023年第8期19卷 727-740页

作者： Álvaro Lassaletta Javier S.Morales Pedro L.Valenzuela Borja Esteso Lisa S.Kahalley Donald J.Mabbott Soumya Unnikrishnan elena panizo Felipe Calvo Radiation Oncology Department Clínica Universidad de NavarraCalle Marquesado de Santa Marta 128027 MadridSpain Pediatric Neuro-Oncology Unit Hospital Infantil Universitario Niño JesúsMadridSpain MOVE-IT Research Group Department of Physical EducationFaculty of Education SciencesUniversity of CadizCádizSpain Biomedical Research and Innovation Institute of Cádiz(INiBICA)Research Unit Puerta del Mar University HospitalUniversity of CádizCádizSpain Physical Activity and Health Research Group(PaHerg) Research Institute of the Hospital 12 de Octubre(‘imas12’)MadridSpain Systems Biology Department University of AlcaláMadridSpain Clinical Neuropsychology Unit Psychiatry and Clinical Psychology DepartmentHospital Infantil Universitario Niño JesúsMadridSpain Baylor College of Medicine HoustonTXUSA Texas Children’s Hospital HoustonTXUSA The Hospital for Sick Children TorontoONCanada The University of Toronto TorontoONCanada University of California School of Medicine San DiegoLa JollaCAUSA

Background Advances in cancer treatments,particularly the development of radiation therapy,have led to improvements in survival outcomes in children with brain ***,radiation therapy is associated with significant long-term neurocognitive *** 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 *** pooled mean differences(expressed as Z scores)were calculated using a random effects method for those endpoints analyzed by a minimum of three *** Totally 10 studies(n=630 patients,average age range:1–20 years)met the inclusion *** who had received PBRT achieved significantly higher scores(difference in Z scores ranging from 0.29–0.75,all P0.05 in main analyses or sensitivity analyses)were found for nonverbal memory,verbal working memory and working memory index,processing speed index,or focused *** Pediatric brain tumor patients who receive PBRT achieve significantly higher scores on most neurocognitive outcomes than those who receive *** studies with long-term follow-ups are needed to confirm these results.

关键词： Brain health Childhood cancer Intelligence quotient Radiotherapy

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