Table 3.
Percent With Severe Neurocognitive Impairment by Treatment Exposure
| Domain/Specific Ability | No CRT (n = 214) |
18 Gy (n = 167) |
24 Gy (n = 186) |
P* | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mean | SD | % Impairment | 95% CI | Mean | SD | % Impairment | 95% CI | Mean | SD | % Impairment | 95% CI | ||
| Intelligence | 9.3 | 5.4 to 13.2 | 12.0 | 7.1 to 16.9 | 27.0 | 20.6 to 33.4 | < .001 | ||||||
| Full scale | 0.0 | 0.9 | 3.7 | 1.2 to 6.3 | –0.2 | 0.9 | 5.4 | 2.0 to 8.8 | –0.5 | 1.1 | 10.3 | 5.9 to 14.7 | < .001 |
| Verbal | –0.2 | 1.1 | 7.5 | 4.0 to 11.0 | –0.6 | 1.1 | 11.4 | 6.6 to 16.2 | –0.8 | 1.2 | 21.0 | 15.1 to 26.8 | < .001 |
| Perceptual | 0.1 | 0.9 | 5.1 | 2.2 to 8.1 | 0.1 | 0.9 | 3.6 | 0.8 to 6.4 | –0.3 | 1.1 | 14.1 | 9.1 to 19.2 | < .001 |
| Academics | 6.1 | 2.9 to 9.3 | 9.2 | 4.8 to 13.6 | 15.4 | 10.1 to 20.6 | .002 | ||||||
| Word reading | –0.2 | 0.6 | 2.3 | 0.3 to 4.4 | –0.4 | 0.6 | 1.8 | 0.0 to 3.9 | –0.6 | 0.8 | 6.0 | 2.6 to 9.5 | < .001 |
| Mathematics | –0.4 | 0.9 | 4.7 | 1.8 to 7.5 | –0.6 | 0.9 | 8.6 | 4.3 to 12.9 | –0.9 | 1.1 | 14.0 | 8.9 to 19.0 | < .001 |
| Attention | 14.5 | 9.8 to 19.2 | 21.5 | 15.2 to 27.8 | 31.1 | 24.4 to 37.9 | < .001 | ||||||
| Focus | –0.1 | 1.2 | 8.4 | 4.7 to 12.1 | –0.2 | 1.4 | 8.5 | 4.2 to 12.7 | –0.4 | 1.5 | 14.1 | 9.0 to 19.1 | .045 |
| Sustain | –0.1 | 1.6 | 7.9 | 4.3 to 11.6 | –0.6 | 2.6 | 12.8 | 7.7 to 17.9 | –0.9 | 2.5 | 20.4 | 14.6 to 26.3 | .003 |
| Variability | –0.1 | 1.1 | 6.1 | 2.9 to 9.3 | –0.4 | 1.3 | 10.4 | 5.7 to 15.0 | –0.7 | 1.4 | 14.4 | 9.3 to 19.5 | < .001 |
| Memory | 13.1 | 8.6 to 17.6 | 18.7 | 12.7 to 24.6 | 30.6 | 24.0 to 37.3 | < .001 | ||||||
| New learning | 0.1 | 1.1 | 4.7 | 1.8 to 7.5 | –0.2 | 1.2 | 8.4 | 4.2 to 12.7 | –0.7 | 1.3 | 18.3 | 12.7 to 23.8 | < .001 |
| Short-term recall | 0.0 | 1.1 | 9.3 | 5.4 to 13.2 | –0.2 | 1.2 | 9.0 | 4.7 to 13.4 | –0.7 | 1.3 | 16.1 | 10.8 to 21.4 | < .001 |
| Long-term recall | –0.1 | 1.1 | 6.5 | 3.2 to 9.9 | –0.3 | 1.2 | 10.2 | 5.6 to 14.9 | –0.7 | 1.4 | 18.8 | 13.2 to 24.4 | < .001 |
| Span | 0.0 | 1.0 | 2.3 | 0.3 to 4.4 | –0.3 | 1.0 | 5.4 | 2.0 to 8.8 | –0.6 | 1.1 | 12.9 | 8.1 to 17.7 | < .001 |
| Processing speed | 16.8 | 11.8 to 21.8 | 16.9 | 11.2 to 22.6 | 27.0 | 20.6 to 33.4 | .013 | ||||||
| Motor | –0.9 | 1.3 | 15.9 | 11.0 to 20.8 | –0.9 | 1.3 | 16.9 | 11.2 to 22.6 | –1.2 | 1.5 | 24.9 | 18.6 to 31.1 | .11 |
| Visual | 0.1 | 1.0 | 3.3 | 0.9 to 5.7 | –0.1 | 0.8 | 2.4 | 0.1 to 4.8 | –0.6 | 1.0 | 10.3 | 5.9 to 14.6 | < .001 |
| Visual-motor | –0.1 | 1.0 | 1.9 | 0.1 to 3.7 | –0.3 | 0.9 | 5.5 | 2.0 to 8.9 | –0.7 | 0.9 | 9.2 | 5.0 to 13.4 | < .001 |
| Executive function | 15.9 | 11.0 to 20.8 | 23.0 | 16.6 to 29.5 | 31.7 | 25.0 to 38.4 | < .001 | ||||||
| Flexibility | –0.5 | 1.7 | 14.0 | 9.4 to 18.7 | –0.8 | 1.7 | 18.8 | 12.8 to 24.7 | –1.2 | 1.9 | 26.5 | 20.1 to 32.8 | < .001 |
| Fluency | –0.3 | 0.9 | 5.6 | 2.5 to 8.7 | –0.4 | 1.1 | 8.4 | 4.2 to 12.6 | –0.8 | 1.0 | 15.6 | 10.4 to 20.8 | < .001 |
| Working memory | –0.2 | 0.9 | 0.5 | 0.0 to 1.4 | –0.4 | 0.9 | 0.6 | 0.0 to 1.8 | –0.5 | 0.9 | 2.7 | 0.4 to 5.0 | < .001 |
| Behavior rating | 5.7 | 2.6 to 8.8 | 12.7 | 7.6 to 17.7 | 16.7 | 11.3 to 22.0 | < .001 | ||||||
| Inhibition | –0.1 | 1.0 | 4.7 | 1.9 to 7.6 | –0.1 | 1.1 | 7.8 | 3.7 to 11.9 | –0.2 | 1.0 | 6.5 | 2.9 to 10.0 | .30 |
| Shift | –0.1 | 1.1 | 6.6 | 3.3 to 10.0 | –0.4 | 1.2 | 10.8 | 6.1 to 15.6 | –0.7 | 1.3 | 17.2 | 11.8 to 22.6 | < .001 |
| Emotional control | –0.1 | 1.2 | 6.2 | 2.9 to 9.4 | –0.5 | 1.3 | 14.5 | 9.1 to 19.8 | –0.7 | 1.3 | 17.7 | 12.3 to 23.2 | < .001 |
| Self-monitor | 0.1 | 1.1 | 4.7 | 1.9 to 7.6 | –0.1 | 1.2 | 8.4 | 4.2 to 12.7 | –0.3 | 1.2 | 7.5 | 3.7 to 11.3 | .004 |
| Cognitive rating | 7.6 | 4.0 to 11.2 | 9.6 | 5.1 to 14.1 | 11.8 | 7.2 to 16.5 | .15 | ||||||
| Initiation | 0.0 | 1.0 | 3.3 | 0.9 to 5.7 | –0.2 | 1.1 | 6.6 | 2.8 to 10.4 | –0.4 | 1.3 | 10.8 | 6.3 to 15.2 | .001 |
| Working memory | –0.5 | 1.3 | 13.7 | 9.1 to 18.4 | –0.7 | 1.4 | 21.1 | 14.9 to 27.3 | –1.1 | 1.4 | 30.6 | 24.0 to 37.3 | < .001 |
| Planning | –0.1 | 1.0 | 6.2 | 2.9 to 9.4 | –0.2 | 1.2 | 7.2 | 3.3 to 11.2 | –0.4 | 1.2 | 10.8 | 6.3 to 15.2 | .007 |
| Task completion | –0.1 | 1.1 | 4.7 | 1.9 to 7.6 | –0.2 | 1.2 | 7.2 | 3.3 to 11.2 | –0.5 | 1.3 | 10.2 | 5.9 to 14.6 | .002 |
| Organization | –0.1 | 1.1 | 7.1 | 3.6 to 10.6 | –0.1 | 1.1 | 4.8 | 1.6 to 8.1 | –0.4 | 1.1 | 7.0 | 3.3 to 10.7 | .011 |
NOTE. Mean and SD are represented in age-adjusted z scores, referenced to nationally representative norms. Percent impairment is defined as age-adjusted z score of −2.0 or less.
Abbreviations: CRT, cranial radiation therapy; SD, standard deviation.
*
Group P value from Cochran-Mantel-Haenszel χ2 test of linear association comparing rates of impairment for domains, and group P values comparing mean standardized scores for specific abilities.