Abstract B044: Dosimetric association between critical brain structure dose and scholastic achievement in pediatric brain tumor survivors
Bibliographic record
Abstract
Abstract Purpose: Radiotherapy (RT) causes cognitive deficits in pediatric brain tumor survivors (PBTS). Cognitive deficits have traditionally been measured using exams such as serial IQ tests administered after diagnosis. Scholastic data captures a student’s academic achievement before, during, and after their cancer diagnosis and treatment and is practical for patients and families. Poor educational performance is associated with worse health, higher risk of incarceration, and a higher risk of experiencing future poverty, and educational achievement disparities burdening Black and Hispanic American public school students are well documented. We sought to evaluate the association between dose to brain organs at risk (OARs) historically associated with cognitive decrement and scholastic achievement in PBTS pre- and post-RT.Materials/Methods: With Institutional Review Board approval, we retrospectively analyzed scholastic achievement in PBTS treated with RT at our institution for this pilot. Eligible PBTS all resided within the state of the institution and were treated from 2007-2021. The state’s Department of Education provided scholastic data for grade promotion, transcripts, accommodations, and state-mandated assessments of mathematics and reading in grades 3-11, which were merged with institutional clinical data. Dependent variables of interest were accommodations, grade promotion, and satisfactory performance on state mandated exams. A general linear mixed-effects model assessed the above scholastic dependent variables from the pre- and post-treatment phase and the independent variables of mean OAR dose to the hippocampus (H), corpus callosum (CC), and frontal lobe (FL), volume receiving X Gy dose to an OAR in 5 Gy increments (e.g., V5, V10) to V40 , and an interaction term of the independent variable and time (pre or post-radiotherapy) was the variable of interest, with α=0.1.Results: Fifty PBTS were included in the sample with a median age of 11.6 years at treatment and 7 years of follow-up. Overall, 52% were eligible for free or reduced lunch, and 56% received craniospinal irradiation. V5, V10, V15, and V20 to H. and FL were associated with math performance, and V25, V30, V35, and V40 to FL were associated with reading performance. For each of these models, the estimated change in scholastic outcome was calculated for post-treatment and a 1% increase in volume receiving the dose, all of which showed a decrease in scholastic outcome. There was no dosimetric association between dose and scholastic performance for CC. Conclusions: We present the first report evaluating associations between dosimetry and scholastic performance. Our work identifies an association between H. dose and reading performance and FL dose and math and reading performance on mandated annual state exams. Evaluating scholastic success is an unmet need for PBTS. We demonstrate a novel method using scholastic performance data as a patient-centered metric, leveraging prospectively collected scholastic outcomes already recorded by states. Citation Format: Raymond B. Mailhot Vega, Daniel J. Indelicato, Julie A. Bradley, Erin M. Mobley, Christopher G. Morris, Carla L. Fisher, Adeel Markatia, Yousef Ramahi, Nancy P. Mendenhall, Amy M. Crisp, M. David Miller. Dosimetric association between critical brain structure dose and scholastic achievement in pediatric brain tumor survivors [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pediatric Cancer Research; 2024 Sep 5-8; Toronto, Ontario, Canada. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl):Abstract nr B044.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".