NCOG-30. ENVIRONMENTAL ENRICHMENT AND HEALTH OUTCOMES AFTER RADIATION

Abstract

Abstract Individuals treated with brain radiation (RT) are at a disproportionately increased risk of accelerated aging and symptom burden. The aim of this abstract is to describe the health outcomes experienced by brain tumor (BT) survivors who received Photon (XRT) and Proton-Beam (PBRT) in relation to levels of environmental enrichment (EE). The study employed a cross-sectional cohort design among persons with glioma (WHO Grade 2 and 3) treated with RT approximately 5 years following diagnosis. EE consists of social network/engagement, physical activity, and employment status/financial stability measured by the Berkman-Syme Social Network Index, International Physical Activity Questionnaire, Vocational Index Scale, and two Socioeconomic Questions, respectively. EE level is classified into low, moderate, or high tertile. Montreal Cognitive Assessment measured cognitive function. Cortical atrophy is measured using temporal brain MRI images from the time of diagnosis, 3 years after, and at the time of enrollment. Images were processed using FreeSurfer. MD Anderson Symptom Inventory – BT module was used to measure functional status. Two-Way ANOVA described the health outcomes among individuals who received XRT and PBRT. Thirty-nine participants, 18 with astrocytoma and 19 with oligodendroglioma, completed the study protocol. Eighteen individuals received XRT (5 were categorized into Low EE, 10 to Moderate EE and 3 had High levels of EE) and 21 received PBRT (8 were categorized into Low EE, 7 had Moderate EE and 6 had High EE). Individuals who received XRT and had High levels of EE had higher scores in MoCA, lower cortical atrophy rate, and lower symptom burden than individuals who had Moderate and Low EE. BT survivors are at an increased risk of accelerated aging and progressive neurological decline. Providing an enriched environment may serve to reduce symptom burden, promote healthy brain aging, and improve cognitive and functional status in BT survivors receiving radiation.