QOL-42. BETTER SOCIAL, COGNITIVE, AND ACADEMIC OUTCOMES AMONG PEDIATRIC BRAIN TUMOR SURVIVORS TREATED WITH PROTON VERSUS PHOTON RADIATION THERAPY

Abstract

INTRODUCTION: Proton beam radiotherapy (PBRT) reduces exposure of healthy tissue to radiation, which may minimize late effects in pediatric brain tumor patients. This study compared social, cognitive, and academic outcomes in children treated with PBRT versus photon radiotherapy (XRT). METHODS: Survivors who were >1 year post-radiation (M=6.5, SD=3.27 years) completed cognitive (processing speed, working memory, language, attention, executive function, memory) and academic (reading, writing, math fluency) testing. Parents completed questionnaires assessing survivors' social functioning. RESULTS: XRT (n=29) and PBRT (n=54) groups did not differ on demographic/clinical variables (68.7% male, M age-at-treatment=7.8 years, 51.8% infratentorial tumor, 55.0% craniospinal RT, median RT dose to tumor=54.0 Gy), except for age-at-evaluation (PBRT M=13.23 years, XRT M=16.39 years; p=0.01) and follow-up interval (PBRT M=5.05 years, XRT M=8.59 years; p<0.01). Tumor types included: 21.7% glioma, 38.6% PNET/medulloblastoma, 13.3% ependymoma, 15.7% germ cell, 10.8% other. The PBRT group performed within normal limits (+/-1SD) on most cognitive measures, while the XRT group performed <0.001 to 0.032) and academic tasks (p<0.001), except attention (p>0.05). The PBRT group was also rated as having better social functioning (p<0.05). CONCLUSIONS: Findings suggest PBRT may provide a meaningful benefit over XRT for social, cognitive, and academic outcomes in pediatric brain tumor survivors.