QOL-29. COGNITIVE DEVELOPMENT WITHIN TWO YEARS AFTER CRANIOSPINAL IRRADIATION IN CHILDREN TREATED FOR MEDULLOBLASTOMA: A COMPREHENSIVE ASSESSMENT USING AGE-APPROPRIATE SCALES

Abstract

Abstract BACKGROUND Medulloblastoma 5-years survival rates range from 50-95% across risk classes, underscoring the need to mitigate treatment-related neurocognitive deficits. This study evaluates cognitive outcomes within 2 years post-radiotherapy, considering treatment modalities and various influencing factors. METHODS We conducted a retrospective monocentric study on patients under 18 years old, treated at our hospital from 2007 to 2020, with histologically and molecularly confirmed medulloblastoma, who underwent craniospinal irradiation. Cognitive function was assessed within 24 months post-therapy using age-appropriate Wechsler scales to evaluate verbal comprehension, perceptual reasoning, working memory, and processing speed. Patients were categorized into two groups based on a threshold score of 80, indicating “neurocognitive normality” if scores were ≥80 in all domains or “neurocognitive deficient” if any domain scored <80. Statistical analyses utilized SPSS for descriptive statistics and tests for categorical and continuous variables. RESULTS Among 100 selected patients, 91 completed the evaluations. The average age at diagnosis was 8.47 years, and at the onset of radiotherapy was 8.83 years. Forty-four patients (48%) scored ≥80 in all domains, indicating ‘neurocognitive normality,’ while 47 patients (52%) scored <80 in at least one domain, classified as ‘neurocognitive deficient’. In the descriptive analysis identifying significant differences in the two groups, no significant differences were observed in age, WHO classification, risk class, or pre-surgical shunt. In contrast, significant differences emerged in posterior fossa syndrome frequency, kinetic (p=0.002) and static forms (p<0.001) and in parental education level(p=0.025). CONCLUSION Our findings highlight the multifactorial nature of neurocognitive development in children with medulloblastoma within 2 years post-radiotherapy, identifying postoperative complications and the social environment as significant factors. Notably, specifics of radiotherapy and high-dose chemotherapy did not show a significant impact in this preliminary analysis. Future studies will further investigate the roles of various variables on neurocognitive outcomes, aiming to extend our understanding beyond two years post-radiotherapy.