Doger de Speville Elodie, Robert Charlotte, Perez-Guevara Martin, Grigis Antoine, Bolle Stephanie, Pinaud Clemence, Dufour Christelle, Beaudré Anne, Kieffer Virginie, Longaud Audrey, Grill Jacques, Valteau-Couanet Dominique, Deutsch Eric, Lefkopoulos Dimitri, Chiron Catherine, Hertz-Pannier Lucie, Noulhiane Marion
INSERM U1129, CEA, Paris Descartes University, Paris, France.
UNIACT, Institut Joliot, DRF, Neurospin, CEA, Paris Saclay University, Gif-sur-Yvette, France.
Front Oncol. 2017 Aug 18;7:166. doi: 10.3389/fonc.2017.00166. eCollection 2017.
Pediatric posterior fossa tumor (PFT) survivors who have been treated with cranial radiation therapy often suffer from cognitive impairments that might relate to IQ decline. Radiotherapy (RT) distinctly affects brain regions involved in different cognitive functions. However, the relative contribution of regional irradiation to the different cognitive impairments still remains unclear. We investigated the relationships between the changes in different cognitive scores and radiation dose distribution in 30 children treated for a PFT. Our exploratory analysis was based on a principal component analysis (PCA) and an ordinary least square regression approach. The use of a PCA was an innovative way to cluster correlated irradiated regions due to similar radiation therapy protocols across patients. Our results suggest an association between working memory decline and a high dose (equivalent uniform dose, EUD) delivered to the orbitofrontal regions, whereas the decline of processing speed seemed more related to EUD in the temporal lobes and posterior fossa. To identify regional effects of RT on cognitive functions may help to propose a rehabilitation program adapted to the risk of cognitive impairment.
接受过颅脑放射治疗的小儿后颅窝肿瘤（PFT）幸存者常常患有认知障碍，这可能与智商下降有关。放射治疗（RT）对涉及不同认知功能的脑区有明显影响。然而，区域照射对不同认知障碍的相对贡献仍不清楚。我们调查了30例接受PFT治疗的儿童不同认知评分变化与辐射剂量分布之间的关系。我们的探索性分析基于主成分分析（PCA）和普通最小二乘回归方法。由于患者的放射治疗方案相似，使用PCA是一种对相关照射区域进行聚类的创新方法。我们的结果表明，工作记忆下降与眶额区域接受的高剂量（等效均匀剂量，EUD）之间存在关联，而处理速度的下降似乎与颞叶和后颅窝的EUD更相关。确定RT对认知功能的区域影响可能有助于提出适应认知障碍风险的康复计划。
