To gain a better understanding of the differences between childhood cancer patients with brain tumours when it comes to the impact of radiation therapy on cognition, a new study focused on neighbourhood-level differences.
The study by researchers at St. Jude Children’s Research Hospital showed that children with supportive environments did better than those in neighbourhoods with economic difficulties. The latter also had worse baseline and long-term cognitive outcomes. The findings show that supportive policies and resources at the neighbourhood level may help protect high-risk pediatric brain tumour patients from cognitive decline, according to the press statement by the hospital. The findings were published in Neuro-Oncology.
“At the simplest level, we found that a patient’s environment matters,” said corresponding author Heather Conklin, PhD, St. Jude Department of Psychology and Biobehavioral Sciences said in the statement. “It’s not just the diagnosis or treatment the patient receives. It’s also the family, neighbourhood and support they can access that predicts cognitive outcomes.”
For the research, the study used the economic hardship index (EHI) framework to study how a patient’s neighbourhood is associated with cognitive outcomes. The findings showed that a higher EHI score was linked with those who entered treatment with lower cognitive abilities and those with a greater cognitive decline, especially in math skills, after treatment, according to the statement.
Economic hardship at the neighbourhood level predicted how the patients performed cognitively at baseline, before radiation therapy, and also how much they declined or stayed stable over time, the researchers explained. “The gaps that were present prior to treatment widened over time and had more of a relative impact than the well-established clinical factors, such as age at radiation therapy,” Conklin said.
This is the first time that researchers have used a neighbourhood-level variable rather than a family-specific measure to predict cognitive outcomes in children treated for brain tumours. These findings are important as they give us more nuanced information about the child’s environment and open new areas for future interventions to improve cognitive outcomes.
Moreover, the study suggests that environmental conditions in high-poverty areas strongly affect long-term outcomes. Hence, it will be beneficial if physicians and policymakers implement solutions to address these factors for current and future pediatric patients with brain tumours.