Significant contributions to the scientific literature provide a new result or insight, challenge or disconfirm accepted knowledge, or replicate and extend an important finding from previous research. In Moxon-Emre et al,1 we find all three. The new insight is the apparent importance of the radiotherapy boost as compared with the cranio-spinal radiation (CSR) dose in modeling neurocognitive outcome. The challenge to accepted knowledge comes in the form of the absence of an effect on neurocognitive outcome of reduced CSR dose. Finally, the replication refers to the rate of posterior fossa (PF) mutism and its impact on neurocognitive outcome. While this study contributes in several other ways, I will limit my comments to these three findings.
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