TY - JOUR
T1 - Predicting neurocognitive function in pediatric brain tumor early survivorship
T2 - The neurological predictor scale and the incremental validity of tumor size
AU - McCurdy, Mark D.
AU - Raghubar, Kimberly P.
AU - Christopher, Krystal
AU - Okcu, M. Fatih
AU - Wilde, Elisabeth
AU - Desai, Nilesh
AU - Chu, Zili D.
AU - Gragert, Marsha
AU - Stancel, Heather
AU - Warren, Emily H.
AU - Whitehead, William E.
AU - Grosshans, David
AU - Paulino, Arnold C.
AU - Chintagumpala, Murali
AU - Kahalley, Lisa S.
N1 - Publisher Copyright:
© 2022 Wiley Periodicals LLC.
PY - 2022/9
Y1 - 2022/9
N2 - Background: The Neurological Predictor Scale (NPS) quantifies cumulative exposure to conventional treatment-related neurological risks but does not capture potential risks posed by tumors themselves. This study evaluated the predictive validity of the NPS, and the incremental value of tumor location and size, for neurocognitive outcomes in early survivorship following contemporary therapies for pediatric brain tumors. Procedure: Survivors (N = 69) diagnosed from 2010 to 2016 were administered age-appropriate versions of the Wechsler Intelligence Scales. Hierarchical multiple regressions examined the predictive and incremental validity of NPS score, tumor location, and tumor size. Results: Participants (51% female) aged 6-20 years (M = 13.22, SD = 4.09) completed neurocognitive evaluations 5.16 years (SD = 1.29) postdiagnosis. The NPS significantly predicted Full-Scale Intelligence Quotient (FSIQ; ΔR2=.079), Verbal Comprehension Index (VCI; ΔR2= 0.051), Perceptual Reasoning Index (PRI; ΔR2= 0.065), and Processing Speed Index (PSI; ΔR2= 0.049) performance after controlling for sex, age at diagnosis, and maternal education. Tumor size alone accounted for a significant amount of unique variance in FSIQ (ΔR2= 0.065), PRI (ΔR2 = 0.076), and PSI (ΔR2= 0.080), beyond that captured by the NPS and relevant covariates. Within the full model, the NPS remained a significant independent predictor of FSIQ (β = −0.249, P = 0.016), VCI (β = −0.223, P = 0.048), and PRI (β = −0.229, P = 0.037). Conclusions: Tumor size emerged as an independent predictor of neurocognitive functioning and added incrementally to the predictive utility of the NPS. Pretreatment disease burden may provide one of the earliest markers of neurocognitive risk following contemporary treatments. With perpetual treatment advances, measures quantifying treatment-related risk may need to be updated and revalidated to maintain their clinical utility.
AB - Background: The Neurological Predictor Scale (NPS) quantifies cumulative exposure to conventional treatment-related neurological risks but does not capture potential risks posed by tumors themselves. This study evaluated the predictive validity of the NPS, and the incremental value of tumor location and size, for neurocognitive outcomes in early survivorship following contemporary therapies for pediatric brain tumors. Procedure: Survivors (N = 69) diagnosed from 2010 to 2016 were administered age-appropriate versions of the Wechsler Intelligence Scales. Hierarchical multiple regressions examined the predictive and incremental validity of NPS score, tumor location, and tumor size. Results: Participants (51% female) aged 6-20 years (M = 13.22, SD = 4.09) completed neurocognitive evaluations 5.16 years (SD = 1.29) postdiagnosis. The NPS significantly predicted Full-Scale Intelligence Quotient (FSIQ; ΔR2=.079), Verbal Comprehension Index (VCI; ΔR2= 0.051), Perceptual Reasoning Index (PRI; ΔR2= 0.065), and Processing Speed Index (PSI; ΔR2= 0.049) performance after controlling for sex, age at diagnosis, and maternal education. Tumor size alone accounted for a significant amount of unique variance in FSIQ (ΔR2= 0.065), PRI (ΔR2 = 0.076), and PSI (ΔR2= 0.080), beyond that captured by the NPS and relevant covariates. Within the full model, the NPS remained a significant independent predictor of FSIQ (β = −0.249, P = 0.016), VCI (β = −0.223, P = 0.048), and PRI (β = −0.229, P = 0.037). Conclusions: Tumor size emerged as an independent predictor of neurocognitive functioning and added incrementally to the predictive utility of the NPS. Pretreatment disease burden may provide one of the earliest markers of neurocognitive risk following contemporary treatments. With perpetual treatment advances, measures quantifying treatment-related risk may need to be updated and revalidated to maintain their clinical utility.
KW - Cognitive function
KW - late effects
KW - outcomes
KW - proton radiation therapy
UR - http://www.scopus.com/inward/record.url?scp=85131952849&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85131952849&partnerID=8YFLogxK
U2 - 10.1002/pbc.29803
DO - 10.1002/pbc.29803
M3 - Article
C2 - 35709014
AN - SCOPUS:85131952849
SN - 1545-5009
VL - 69
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 9
M1 - e29803
ER -