An Exploratory Study of Biologic and Pathophysiologic Efects of Radiation Therap

这项微创研究旨在探索 对儿童中枢神经系统进行辐射，试图1）获得有关病理生理学的信息 2）探索神经心理学缺陷与放射性损伤的关系， 生物标志物和神经影像学异常，3）记录神经行为的变化 通过纵向综合神经心理学评估功能， 各种放射治疗技术，4）描述儿科患者生活质量的变化 接受过放射治疗的患者，以及5）试图识别儿童在增加 辐射诱发神经毒性的风险。我们特别评估了 通过测量血管生成相关的细胞因子、蛋白质和细胞， VEGF、bFGF、血小板反应蛋白、TNF-α、IL-12、IL-8、循环内皮细胞（CEC）和 血液和尿液标本中的基质金属蛋白酶。我们正在评估 血管生成和血管分布，包括动态磁敏感造影剂灌注 和动态增强核磁共振扫描将通过测量生物标志物来表征神经毒性 与神经毒性相关，并记录神经行为功能的变化 通过纵向综合评估。此外，我们还将介绍 生活质量（QOL），评估记忆的变化，定义眼科研究的变化 并检测与辐射相关的听力测定变化。患者 年龄在22岁以下的患者被转诊到NCI接受原发性CNS肿瘤的放射治疗， 合资格的.大约有21名患者入组，并进行了纵向随访， 多学科专家团队，包括儿科肿瘤学，眼科学， 放射学听力学和神经心理学

This minimally invasive study is designed to explore various biologic effects of radiation on the pediatric CNS in an attempt to 1) obtain information on the pathophysiology of radiation-induced damage, 2) explore the association of neuropsychological deficits with biologic markers and neuroimaging abnormalities, 3) document changes in neurobehavioral functioning through longitudinal comprehensive neuropsychological assessments with comparison of various radiation therapy techniques, 4) describe changes in quality of life in pediatric patients who have received radiation therapy, and 5) attempt to identify children at increased risk of radiation-induced neurotoxicity. We are specifically evaluating effects on angiogenesis by measurement of angiogenesis related cytokines, proteins and cells including VEGF, bFGF, thrombospondin, TNF-alpha, IL-12, IL-8, circulating endothelial cells (CECs) and matrix metalloproteinases in blood and urine specimens. We are evaluating the changes in angiogenesis and vascularity by imaging, including dynamic susceptibility contrast perfusion and dynamic enhanced MRI scans. Neurotoxicity will be characterized by measuring biomarkers associated with neurotoxicity and documentation of changes in neurobehavioral functioning through longitudinal comprehensive assessments. In addition, we will describe changes in quality of life (QOL), assess changes in memory, define changes in ophthalmologic studies associated with radiation and detect changes in audiometry associated with radiation. Patients under 22 yrs of age who are referred to NCI for radiation therapy of a primary CNS tumor are eligible. Approximately 21 patients have enrolled and are followed longitudinally by a multidisciplinary team of specialists, including those from pediatric oncology, ophthalmology, radiology, audiology and neuropsychology.