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

项目摘要 在美国，大多数接受癌症治疗的儿童将获得长期生存， 这对不断增长的人口构成了挑战。特别是儿童脑肿瘤幸存者， 残疾、教育困难、社会问题和医疗残疾。颅脑放射治疗是一种 这是一种基本的救生治疗，但与认知能力下降有关。质子束放射治疗（PBRT） 这是儿科脑肿瘤治疗最有希望的最新进展之一。拟议的医疗优势 PBRT的关键在于质子束辐射输送的精确性， 同时最小化对周围组织的辐射。通过减少对健康脑组织的剂量，PBRT可以节省 认知功能和减轻症状负担优于常规光子或X射线照射（XRT） 从而在生存中获得更大的功能独立性。 拟定的多样性补充研究利用了在放射治疗期间收集的母体R 01数据 (RT)在这项多国研究中检查症状负荷和毒性的急性经历的时间点。 PBRT和XRT儿童脑肿瘤组之间前瞻性评估的急性结局比较 迄今尚未发表，这是一项新颖的研究，将告知我们对RT模态的理解 差异提出了以下目标，这些目标映射到亲本R 01的目标1上：（1a）比较急性 儿科脑肿瘤患者中按RT类型（PBRT与XRT）列出的症状负荷/毒性，以及（1b）检查风险 RT期间的症状负荷/毒性因素。多样性补充研究在母公司范围内 R 01同时也为这一研究领域提供了具有临床意义的扩展。

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.