How to Prevent Memory Loss in Kids With Brain Tumors During Radiotherapy

Pencil beam scanning (PBS), a form of proton beam radiotherapy offers the best chance to preserve memory, reasoning skills and other higher brain functions while treating brain tumors in kids with radiation.

Highlights:

Pencil beam scanning (PBS), a form of proton beam radiotherapy associated with the least damage to memory, reasoning skills and other higher brain functions in children treated with radiation for brain tumor
In addition to surgery and chemo, radiotherapy plays an important role in treating childhood brain tumors in children, but it is important to protect brain tissue from radiation-induced injury
Three types of radiotherapy are normally used to treat brain tumors with minimal damage to the normal brain tissue namely volumetric modulated arc therapy (VMAT), double scattering proton therapy (DSPT) or pencil beam scanning proton therapy (PBS).

Pencil beam scanning (PBS), a form of proton beam radiotherapy is the most ideal therapy to protect memory and other higher brain functions while treating brain tumors in kids with radiation, reveals a recent study at Aarhus University Hospital, Denmark.

The findings of the study were presented at the ESTRO 38 conference by Laura Toussaint, a PhD student at the Department of Medical Physics, Aarhus University Hospital, Denmark.

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‘Pencil beam scanning proton therapy appears to do the least damage to the parts of the brain critical to children’s memory. Therefore, pencil beam radiotherapy helps preserve memory in kids with brain tumor.’
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Radiation To Head Area Affects Memory

Earlier studies have shown that radiation to certain areas of the brain, such as the hippocampus and temporal lobes and hippocampus can affect higher brain functions particularly memory.

The current study hoped to find how various forms of radiotherapy affect ed the brain structures involved in memory, for example, the temporal lobes and hippocampus. The study analyzed 30 different structures in the brains of children treated with radiation for brain tumor to determine the effects.

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Radiation therapy leads to reduced volume in hippocampus, which is responsible for memory, so children with brain tumor struggle to remember recent events. It is usually seen in patients suffering from Alzheimer's disease, dementia, brain injury, amnesia, encephalitis.

Effects of Various Forms of Radiation on Memory

The study team conducted carried studies on ten different children treated for brain tumor
All children were diagnosed with craniopharyngioma, a type of brain tumor occurring in the central portion of the brain
Using CT and MRI scans the team was able to precisely localize the sites of the 30 structures in the childrens’ brains important for memory and other higher functions to analyze the effects of radiation on these.
Each child was treated with the three types of radiotherapy namely volumetric modulated arc therapy (VMAT), double scattering proton therapy (DSPT) or pencil beam scanning proton therapy (PBS).
All the above are advanced forms of radiotherapy treatments but DSPT and PBS are a form of proton therapy, which specifically targets the tumor tissue with little or no damage to surrounding normal tissue. These treatments require expensive equipment and are not widely available in all centers
PBS is a particularly precision type radiotherapy that uses a very narrow proton beam to deliver the radiation
The three forms of radiation for each child were then compared to see which type of radiation treatment caused the least damage to the 30 structures and categorized the radiation dose to each of these structures as low medium and high
It was seen that radiation dose to the temporal lobe was the least with PBS treatment, on comparison with both the DSPT and VMAT treatments
Also, it was noted that 41 percent of the left hippocampus volume received much lower doses of radiation with DSPT form of radiation and was totally spared with PBS treatment

The findings of the study suggest that the proton therapies, particularly the PBS treatment would cause the least impairment of children’s memory and other functions while assessing the effects of various forms of radiation treatment for childhood brain tumors

Ms Toussaint, said: "The use of proton therapy has been expanding rapidly over the last decade and is becoming more and more available for cancer patients, especially for children. This also means that more research can take place. The next step would be to confirm this finding with clinical research in patients."

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Summary

Proton beam radiation therapy, particularly pencil beam scanning (PBS) is effective in preserving memory and other brain functions while treating with brain tumors. These findings will pave the way for further research in this area as well as making the treatment more widely available and accessible. Currently, there are about 25 centers in Europe offering proton beam therapy and a further 19 being planned or underway.

Reference:

Pencil beam radiotherapy may help preserve memory in kids with brain tumours - (https://www.estro.org/)

Source-Medindia

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