ESTRO 2025 - Abstract Book

S654

Clinical - CNS

ESTRO 2025

Figure 2 Correlograms for structural connectivity (SC) and functional connectivity (FC) between structural hubs and functional hubs (hub-hub connections) in impaired vs unimpaired patients with associated p value maps (Mann-Whitney U tests)

Conclusion: RT adversely affects functional hubs in a dose-dependent manner, contributing to cognitive dysfunction. Protecting these regions from dose may potentially mitigate cognitive side effects in glioma patients. The altered structural and functional hub-connectivity pattern may provide further evidence for the network failure theory as common pathway for cognitive impairments.

Keywords: neurocognition, functional MRI, connectome

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Digital Poster Proton craniospinal irradiation (pCSI) for leptomeningeal disease from solid tumors: feasibility, toxicity and clinical outcomes Omer Gal 1 , Alonso La Rosa 1 , Matthew D. Hall 1 , Robert H. Press 1 , Yazmin Odia 2 , Zhijian Chen 2 , zachary fellows 1 , Andrew Wroe 1 , Alonso N. Gutierrez 1 , Minesh P. Mehta 1 , Rupesh Kotecha 1 1 Department of Radiation Oncology, Miami Cancer Institute, Miami, USA. 2 Department of Neuro-Oncology, Miami Cancer Institute, Miami, USA Purpose/Objective: Proton craniospinal irradiation (pCSI) is an emerging treatment option for select patients with leptomeningeal disease (LMD), with a prospective trial recently reporting improved overall survival (OS) and CNS-progression-free survival (PFS) compared to involved field irradiation. However, concerns remain regarding the applicability to standard practice, real-world toxicities, and efficacy outcomes.