Neurocognitive Outcomes Following Proton Beam Radiation Therapy for Treatment of

描述（由申请人提供）：该候选人Lisa Schum Kahalley博士是贝勒医学院儿科心理学系助理教授，同时在德克萨斯州儿童癌症中心担任第二职位。拟议的职业发展奖概述了重要的指导、培训和研究经验，为卡哈雷博士在神经认知晚期效应研究方面的独立研究项目做准备。支持该应用程序的指导委员会由儿科神经心理学（Doug Ris博士）、神经肿瘤学（Fatih Okcu博士、Murali Chintagumpala博士）和纵向统计学（Paras Mehta博士）方面经验丰富的研究人员和临床医生组成。他们将监督候选人在神经心理学、纵向研究方法、科学写作和资助方面的专业培训，为她过渡到神经认知结果研究和研究独立做好准备。拟议的研究计划将在这些具体的重点领域提供应用经验。脑肿瘤幸存者有持续治疗相关认知障碍的风险。人们对使用质子束放射治疗（PBRT）治疗儿童脑肿瘤的兴趣持续增长，因为许多人相信这种技术可以提高生存率，同时也保持生活质量。许多人预示着PBRT的临床潜力，即在不牺牲疾病控制的情况下，通过最小化对健康脑组织的损害来保护认知功能。尽管如此，迄今为止还没有关于PBRT治疗儿童脑肿瘤后认知结果的发表报告。该提案包括两项研究，一项是横断面研究，一项是纵向研究，旨在最大限度地提高这5年资助期的经验收益。研究1是一项前瞻性的、纵向的神经认知结果和儿童脑肿瘤患者接受PBRT治疗与单独手术治疗的变化。研究2是一项横断面比较先前接受PBRT治疗与传统放射治疗的儿童脑肿瘤幸存者的神经认知结果。该建议与NCI的战略目标是一致的，即提高癌症幸存者的生活质量，促进安全和公平的癌症治疗，并促进知情决策。结果将具有临床价值，及时提供神经认知功能的初步报告和治疗方式之间的比较，这将是对PBRT晚期效应文献的重要补充。这种研究环境的显著优势将促进这些研究的成功实施。尤其值得一提的是，德州儿童癌症中心拥有全美最大的儿童神经肿瘤学项目之一，并可进入美国目前为数不多的质子治疗中心之一，用于治疗儿童脑肿瘤。

DESCRIPTION (provided by applicant): This candidate, Lisa Schum Kahalley, PhD, is an Assistant Professor in the Section of Psychology, Department of Pediatrics, at Baylor College of Medicine, with a secondary appointment in the Texas Children's Cancer Center. The proposed career development award outlines critical mentoring, training, and research experiences to prepare Dr. Kahalley for an independent research program in neurocognitive late effects research. The mentoring committee supporting this application consists of experienced researchers and clinicians in pediatric neuropsychology (Doug Ris, PhD), neuro-oncology (Fatih Okcu, MD, Murali Chintagumpala, MD), and longitudinal statistics (Paras Mehta, PhD). They will oversee this candidate's specialized training in neuropsychology, longitudinal research methods, and scientific writing and grantsmanship to prepare her to transition into neurocognitive outcome research and research independence. The proposed research plan will provide applied experience in these specific areas of focus. Brain tumor survivors are at risk for lasting treatment-related cognitive impairment. Interest in the use of proton beam radiation therapy (PBRT) for treatment of pediatric brain tumor continues to grow as many believe this technique could improve survival rates while also preserving quality of life outcomes. Many herald the clinical potential of PBRT to spare cognitive functioning by minimizing damage to healthy brain tissue without sacrificing disease control. Still, there are no published reports to date of cognitive outcomes following PBRT for pediatric brain tumor. This proposal includes two studies, one cross-sectional and one longitudinal, designed to maximize the empirical yield for this 5-year funding period. Study 1 is a prospective, longitudinal examination of neurocognitive outcomes and changes over time among patients treated for pediatric brain tumors with PBRT versus surgery alone. Study 2 is a cross-sectional comparison of neurocognitive outcomes between survivors of pediatric brain tumor previously treated with PBRT versus conventional radiation therapy. This proposal is consistent with NCI's strategic objectives to improve the quality of life for cancer survivors, promote safe and equitable cancer care, and foster informed decision making. Results will have clinical value, providing a timely initial report of neurocognitive functioning and comparison between treatment modalities that will be a notable addition to the sparse existent literature in PBRT late effects. Remarkable advantages of this research environment will facilitate the successful execution of these studies. In particular, Texas Children's Cancer Center has one of the largest pediatric neuro-oncology programs in the country with access to one of the few proton therapy centers in the US currently open for the treatment of pediatric brain tumor.