Atypical white matter volume development in children following craniospinal irradiation

Wilburn E. Reddick, John O. Glass, Shawna L. Palmer, Shingjie Wu, Amar Gajjar, James W. Langston, Larry E. Kun, Xiaoping Xiong, Raymond K. Mulhern

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Most children with medulloblastoma (MB), the second most common pediatric brain tumor, have a 70% probability of survival. However, survivors who receive aggressive therapy are at significant risk of cognitive deficits that have been associated with lower volumes of normal-appearing white matter (NAWM). We hypothesized that cranial irradiation inhibited normal brain volume development in these survivors. We retrospectively analyzed 324 MRI studies of 52 patients with histologically proven MB treated with surgery and 35 to 40 Gy craniospinal irradiation, with or without chemotherapy. The volume of NAWM and that of cerebrospinal fluid were quantified from a single index section and compared with those of healthy, age-similar control subjects. A quadratic random coefficient model was used to identify trends in brain volume with increasing age. Patients treated for MB at younger ages demonstrated substantially less development of NAWM volume than did their healthy peers. Younger age at the time of irradiation and the need for a ventricular shunt were significantly associated with reduced NAWM volume. NAWM and craniospinal fluid volume differences between patients who had shunts and those without resolved over a period of four to five years. NAWM volume is known to be associated with neurocognitive test performance, which shows deficiencies after cranial irradiation early in life. Therefore, volumetric monitoring of brain development can be used to guide the care of survivors, assess the toxicity of previous and current clinical trials, and aid in the design of therapies that minimize toxicity.

Original languageEnglish (US)
Pages (from-to)12-19
Number of pages8
JournalNeuro-Oncology
Volume7
Issue number1
DOIs
StatePublished - Jan 1 2005

Fingerprint

Craniospinal Irradiation
Child Development
Medulloblastoma
Cranial Irradiation
Survivors
Brain
Brain Neoplasms
Cerebrospinal Fluid
White Matter
Clinical Trials
Pediatrics
Drug Therapy
Survival
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Clinical Neurology

Cite this

Reddick, W. E., Glass, J. O., Palmer, S. L., Wu, S., Gajjar, A., Langston, J. W., ... Mulhern, R. K. (2005). Atypical white matter volume development in children following craniospinal irradiation. Neuro-Oncology, 7(1), 12-19. https://doi.org/10.1215/S1152851704000079

Atypical white matter volume development in children following craniospinal irradiation. / Reddick, Wilburn E.; Glass, John O.; Palmer, Shawna L.; Wu, Shingjie; Gajjar, Amar; Langston, James W.; Kun, Larry E.; Xiong, Xiaoping; Mulhern, Raymond K.

In: Neuro-Oncology, Vol. 7, No. 1, 01.01.2005, p. 12-19.

Research output: Contribution to journalArticle

Reddick, WE, Glass, JO, Palmer, SL, Wu, S, Gajjar, A, Langston, JW, Kun, LE, Xiong, X & Mulhern, RK 2005, 'Atypical white matter volume development in children following craniospinal irradiation', Neuro-Oncology, vol. 7, no. 1, pp. 12-19. https://doi.org/10.1215/S1152851704000079
Reddick WE, Glass JO, Palmer SL, Wu S, Gajjar A, Langston JW et al. Atypical white matter volume development in children following craniospinal irradiation. Neuro-Oncology. 2005 Jan 1;7(1):12-19. https://doi.org/10.1215/S1152851704000079
Reddick, Wilburn E. ; Glass, John O. ; Palmer, Shawna L. ; Wu, Shingjie ; Gajjar, Amar ; Langston, James W. ; Kun, Larry E. ; Xiong, Xiaoping ; Mulhern, Raymond K. / Atypical white matter volume development in children following craniospinal irradiation. In: Neuro-Oncology. 2005 ; Vol. 7, No. 1. pp. 12-19.
@article{ea45bce873364d10abe2c16c4a2b99e7,
title = "Atypical white matter volume development in children following craniospinal irradiation",
abstract = "Most children with medulloblastoma (MB), the second most common pediatric brain tumor, have a 70{\%} probability of survival. However, survivors who receive aggressive therapy are at significant risk of cognitive deficits that have been associated with lower volumes of normal-appearing white matter (NAWM). We hypothesized that cranial irradiation inhibited normal brain volume development in these survivors. We retrospectively analyzed 324 MRI studies of 52 patients with histologically proven MB treated with surgery and 35 to 40 Gy craniospinal irradiation, with or without chemotherapy. The volume of NAWM and that of cerebrospinal fluid were quantified from a single index section and compared with those of healthy, age-similar control subjects. A quadratic random coefficient model was used to identify trends in brain volume with increasing age. Patients treated for MB at younger ages demonstrated substantially less development of NAWM volume than did their healthy peers. Younger age at the time of irradiation and the need for a ventricular shunt were significantly associated with reduced NAWM volume. NAWM and craniospinal fluid volume differences between patients who had shunts and those without resolved over a period of four to five years. NAWM volume is known to be associated with neurocognitive test performance, which shows deficiencies after cranial irradiation early in life. Therefore, volumetric monitoring of brain development can be used to guide the care of survivors, assess the toxicity of previous and current clinical trials, and aid in the design of therapies that minimize toxicity.",
author = "Reddick, {Wilburn E.} and Glass, {John O.} and Palmer, {Shawna L.} and Shingjie Wu and Amar Gajjar and Langston, {James W.} and Kun, {Larry E.} and Xiaoping Xiong and Mulhern, {Raymond K.}",
year = "2005",
month = "1",
day = "1",
doi = "10.1215/S1152851704000079",
language = "English (US)",
volume = "7",
pages = "12--19",
journal = "Neuro-Oncology",
issn = "1522-8517",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Atypical white matter volume development in children following craniospinal irradiation

AU - Reddick, Wilburn E.

AU - Glass, John O.

AU - Palmer, Shawna L.

AU - Wu, Shingjie

AU - Gajjar, Amar

AU - Langston, James W.

AU - Kun, Larry E.

AU - Xiong, Xiaoping

AU - Mulhern, Raymond K.

PY - 2005/1/1

Y1 - 2005/1/1

N2 - Most children with medulloblastoma (MB), the second most common pediatric brain tumor, have a 70% probability of survival. However, survivors who receive aggressive therapy are at significant risk of cognitive deficits that have been associated with lower volumes of normal-appearing white matter (NAWM). We hypothesized that cranial irradiation inhibited normal brain volume development in these survivors. We retrospectively analyzed 324 MRI studies of 52 patients with histologically proven MB treated with surgery and 35 to 40 Gy craniospinal irradiation, with or without chemotherapy. The volume of NAWM and that of cerebrospinal fluid were quantified from a single index section and compared with those of healthy, age-similar control subjects. A quadratic random coefficient model was used to identify trends in brain volume with increasing age. Patients treated for MB at younger ages demonstrated substantially less development of NAWM volume than did their healthy peers. Younger age at the time of irradiation and the need for a ventricular shunt were significantly associated with reduced NAWM volume. NAWM and craniospinal fluid volume differences between patients who had shunts and those without resolved over a period of four to five years. NAWM volume is known to be associated with neurocognitive test performance, which shows deficiencies after cranial irradiation early in life. Therefore, volumetric monitoring of brain development can be used to guide the care of survivors, assess the toxicity of previous and current clinical trials, and aid in the design of therapies that minimize toxicity.

AB - Most children with medulloblastoma (MB), the second most common pediatric brain tumor, have a 70% probability of survival. However, survivors who receive aggressive therapy are at significant risk of cognitive deficits that have been associated with lower volumes of normal-appearing white matter (NAWM). We hypothesized that cranial irradiation inhibited normal brain volume development in these survivors. We retrospectively analyzed 324 MRI studies of 52 patients with histologically proven MB treated with surgery and 35 to 40 Gy craniospinal irradiation, with or without chemotherapy. The volume of NAWM and that of cerebrospinal fluid were quantified from a single index section and compared with those of healthy, age-similar control subjects. A quadratic random coefficient model was used to identify trends in brain volume with increasing age. Patients treated for MB at younger ages demonstrated substantially less development of NAWM volume than did their healthy peers. Younger age at the time of irradiation and the need for a ventricular shunt were significantly associated with reduced NAWM volume. NAWM and craniospinal fluid volume differences between patients who had shunts and those without resolved over a period of four to five years. NAWM volume is known to be associated with neurocognitive test performance, which shows deficiencies after cranial irradiation early in life. Therefore, volumetric monitoring of brain development can be used to guide the care of survivors, assess the toxicity of previous and current clinical trials, and aid in the design of therapies that minimize toxicity.

UR - http://www.scopus.com/inward/record.url?scp=14644440507&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=14644440507&partnerID=8YFLogxK

U2 - 10.1215/S1152851704000079

DO - 10.1215/S1152851704000079

M3 - Article

C2 - 15701278

AN - SCOPUS:14644440507

VL - 7

SP - 12

EP - 19

JO - Neuro-Oncology

JF - Neuro-Oncology

SN - 1522-8517

IS - 1

ER -