Comparison of Symptom Burden/Toxicity, Neurocognitive Change, and Functional Outcomes in Pediatric Brain Tumor Patients Treated with Proton vs. Photon Radiotherapy.

项目总结 在美国，大多数接受癌症治疗的儿童将实现长期存活，而且存活呈现独特的特征 这对不断增长的人口来说是一个挑战。尤其是儿童脑瘤幸存者，面临神经认知的风险。 残疾、教育困难、社会问题和医疗残疾。颅脑放射治疗是一种 必要的挽救生命的治疗，但与认知能力下降有关。质子束放射治疗(PBRT) 儿科脑瘤治疗最有希望的最新进展之一。拟议的医疗优势 PBRT的关键在于质子束照射的精确度，将最大剂量沉积到临床靶区 同时将对周围组织的辐射降至最低。通过减少对健康脑组织的剂量，PBRT可能会节省 认知功能和减轻症状负担优于传统的光子或X射线照射(XRT) 从而在生存方面获得更大的功能独立性。 拟议的多样性补充研究利用了在ON-放射治疗时收集的父母R01的数据 (RT)在这项多国研究中检查症状负担和毒性的急性经验的时间点。 儿童脑肿瘤PBRT和XRT急性预后前瞻性评估的比较 到目前为止还没有发表，这使这项研究成为一项新的研究，将有助于我们对RT通道的理解 不同之处。提出了映射到亲本R01的目标1的以下目标：(1a)比较急性 儿童脑肿瘤患者放射治疗类型的症状负担/毒性(PBRT与XRT)和(1b)风险评估 RT期间症状负担/毒性的影响因素。多样性补充研究属于家长的范围 R01，同时也提供了这一研究路线的临床有意义的扩展。

PROJECT SUMMARY Most children treated for cancer in the US will achieve long-term survival, and survivorship presents unique challenges for this growing population. Pediatric brain tumor survivors, in particular, are at risk for neurocognitive impairments, educational difficulties, social problems, and medical disabilities. Cranial radiation therapy is an essential lifesaving treatment but is associated with cognitive decline. Proton beam radiation therapy (PBRT) is one of the most promising recent advances in pediatric brain tumor treatment. The proposed medical advantage of PBRT lies in the precision of radiation delivery with proton beams, depositing maximum dose to clinical targets while minimizing radiation to surrounding tissues. By reducing dose to healthy brain tissue, PBRT may spare cognitive functioning and reduce symptom burden better than conventional photon or x-ray irradiation (XRT) leading to greater functional independence in survivorship. The proposed Diversity Supplement Study leverages data collected on the Parent R01 at on-radiotherapy (RT) time points to examine acute experiences of symptom burden and toxicity in this multi-national study. Comparisons of prospectively assessed acute outcomes between PBRT and XRT pediatric brain tumor groups have not been published to date, making this a novel study that will inform our understanding of RT modality differences. The following aims, which map onto Aim 1 of the Parent R01, are proposed: (1a) to compare acute symptom burden/toxicity by RT type (PBRT vs. XRT) in pediatric brain tumor patients and (1b) to examine risk factors of symptom burden/toxicity during RT. The Diversity Supplement Study is within the scope of the Parent R01 while also providing a clinically meaningful expansion of this line of research.