Long-term neuropsychological outcomes of survivors of young childhood brain tumors treated on the Head Start II protocol Journal Article


Authors: Levitch, C. F.; Malkin, B.; Latella, L.; Guerry, W.; Gardner, S. L.; Finlay, J. L.; Sands, S. A.
Article Title: Long-term neuropsychological outcomes of survivors of young childhood brain tumors treated on the Head Start II protocol
Abstract: Background: The Head Start treatment protocols have focused on curing young children with brain tumors while avoiding or delaying radiotherapy through using a combination of high-dose, marrow-Ablative chemotherapy and autologous hematopoietic cell transplantation (AuHCT). Late effects data from treatment on the Head Start II (HS II) protocol have previously been published for short-Term follow-up (STF) at a mean of 39.7 months post-diagnosis. The current study examines long-Term follow-up (LTF) outcomes from the same cohort. Methods: Eighteen HS II patients diagnosed with malignant brain tumors <10 years of age at diagnosis completed a neurocognitive battery and parents completed psychological questionnaires at a mean of 104.7 months' post-diagnosis. Results: There was no significant change in Full Scale IQ at LTF compared to baseline or STF. Similarly, most domains had no significant change from STF, including verbal IQ, performance IQ, academics, receptive language, learning/memory, visual-motor integration, and externalizing behaviors. Internalizing behaviors increased slightly at LTF. Clinically, most domains were within the average range, except for low average mathematics and receptive language. Additionally, performance did not significantly differ by age at diagnosis or time since diagnosis. Of note, children treated with high-dose methotrexate for disseminated disease or atypical teratoid/rhabdoid tumor displayed worse neurocognitive outcomes. Conclusions: These results extend prior findings of relative stability in intellectual functioning for a LTF period. Ultimately, this study supports that treatment strategies for avoiding or delaying radiotherapy using high-dose, marrow-Ablative chemotherapy and AuHCT may decrease the risk of neurocognitive and social-emotional declines in young pediatric brain tumor survivors. © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Keywords: late effects; survivorship; pediatric brain tumors; neurocognitive; intellectual functioning
Journal Title: Neuro-Oncology Practice
Volume: 8
Issue: 5
ISSN: 2054-2577
Publisher: Oxford University Press  
Date Published: 2021-10-01
Start Page: 609
End Page: 619
Language: English
DOI: 10.1093/nop/npab028
PROVIDER: scopus
PMCID: PMC8475224
PUBMED: 34594573
DOI/URL:
Notes: Article -- Export Date: 2 November 2021 -- Source: Scopus
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  1. Stephen Alan Sands
    23 Sands
  2. Benjamin Malkin
    1 Malkin