ID #991 Title: Neurocognitive and Quality of Life Outcomes of Patients with Atypical Teratoid/Rhabdoid Tumor (AT/RT)- A Report from Phase 2 Study (SJATRT) Strata B & C
Aditi Bagchi, Santhosh Upadhyaya, Jason M Ashford, Catherine Billups, Anjali Singh, Eroica Soans, Paul Klimo, Thomas E Merchant, Giles Robinson, Arzu Onar Thomas, Amar Gajjar, Heather ConklinAbstract
Background
Atypical teratoid/rhabdoid tumor (AT/RT) is an aggressive pediatric brain tumor, with a young age of onset, treated with surgery, radiation, and chemotherapy. Young children who have undergone treatment for brain tumors show poor neurocognitive outcomes and health-related quality of life (HRQoL).
Methods
We conducted descriptive statistical analyses for measures of neurocognition, quality of life (QoL), and fatigue administered to patients enrolled on SJATRT (Stratum B < 36 months; Stratum C > 36 months). Non-metastatic stratum B patients received focal RT at >12 months of age, and patients in stratum C received postoperative CSI. Serial neurocognitive and QoL evaluations were conducted at baseline, 12, and 36 months after enrollment. We also incorporated neurocognitive data from standard-of-care evaluations, using measures of the same constructs.
Results
Data were limited for both strata. Stratum B showed mean baseline and 12-month IQs of 86.1±16.5 (n = 9) and 95.0±12 (n = 3), respectively, potentially reflecting recovery after diagnostic surgery. QoL and fatigue scores trended low. For stratum C, patients who received 23.4 cGy CSI had a mean baseline IQ of 95.9±9.2 (n = 8) that dropped to 84.0±8.7 at year 3 (n = 3). Patients receiving a higher dose of CSI had a mean baseline IQ of 85.8±7.1 (n = 4). Based on a limited number of serial scores, verbal reasoning, working memory (WM), attention, processing speed, and executive functions appeared stable over 3 years in patients receiving 23.4 cGy CSI. Mean Qol and fatigue scores were 85.0±11.7 (n = 7) and 84.7±12.5 (n = 8), respectively, with corresponding values in year 3 of 70.8±9.9 (n = 3) and 69.4±14.5(n = 3) for patients receiving 23.4 cGy CSI.
Conclusion
Neurocognitive monitoring in children with brain tumors on clinical trials is necessary for refining treatment and providing support. The results presented may suggest, in a very limited number of patients, the detrimental effects of surgery and irradiation during early development. Findings also highlight the challenges of systematic, long-term monitoring of neurocognition and HRQoL.