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. 2025 May 30;15:1554765. doi: 10.3389/fonc.2025.1554765

Table 3.

Comparison of children’s neurocognitive dysfunction between proton beam therapy and photon irradiation.

RT PBT
Authors Patients Total radiation dose [Gy] Main results Patients Total radiation dose [Gy] Main results
Mash
et al.
(2023)
(27)
10 T: 53.4 Reduction of white matter integrity
Relative significantly lower of cognitive and motor functions (FSIQ, VCI, PRI, WMI)
F group: relative significantly lower overall intelligence, verbal reasoning, visual-motor skills, motor coordination
12 53.5 No reduction of white matter integrity.
No decrease in cognitive and motor functions (FSIQ, VCI, PRI, WMI)
F group: no change in respect to overall intelligence, verbal reasoning, visual-motor skills, motor coordination
Child
et al.
(2021)
(29)
30 F: 54.0
CSI: 54.0
F group: significant decrease concerning FSIQ, verbal and graphomotor switching, math, reading and writing fluency, processing spin, fine motor coordination
CSI: significant impairments in motor skills, processing speed, attention and interpersonal relations, math, reading and writing fluency, processing spin, fine motor coordination
58 F: 50.4
CSI: 54.0
F group: math and writing fluency, processing spin, fine motor coordination
CSI: significant decrease concerning FSIQ, verbal and graphomotor switching, math, reading and writing fluency, processing spin, fine motor coordination
Kahalley
et al.
(2020)
(32)
42 T: 55.8
CSI: 23.4
Significant decrease in global IQ, working memory, and processing speed 37 T: 54.0
CSI: 23.4
Stable intellectual outcomes in most domains (IQ, perceptual reasoning, working memory),(even in the context of CSI)
Processing speed: decrease over time
Gross
et al.
(2019)
(33)
67 F:
CSI:
Relative lower full-scale IQ and processing speed, higher verbal IQ, and general adaptive function
F group: relatively lower PSI
CSI: relative lower VIQ, FSIQ/GAI
58 F:
CSI:
Relative higher full-scale IQ and processing speed, higher verbal IQ, and general adaptive functions
F group: relatively higher PSI
CSI: relative higher VIQ, FSIQ/GAI
Pulsifer
et al.
(2018)
(36)
60 Processing speed and working memory skills were significantly lower at follow-up for patients treated with CSI, regardless of age. 90 52.2 Motor, social interaction, personal living, community living
- no significant change in adaptive functioning was found after PRT, regardless of age or radiation field
Kahalley
et al.
(2016)
(37)
60 T: 54.0
CSI: 23.4
IQ decreased by 1.1 points per year in the RT group. IQ was lower in the RT group (by 12.5 points) compared to the PBT group. 90 T: 54.0
CSI: 23.4
No change in IQ over time.

CSI, craniospinal irradiation; F, focal; FSIQ, Full Scale Intelligence Quotient; GAI, General Ability Index; PRI, Perceptual Reasoning Index; PSI, Processing Speed Index; T, total; VCI, Verbal Comprehension Index; WMI, Working Memory Index.