Neurocognitive & Quality of Life (QOL)

Neurocognitive & Quality of Life (QOL) in proton/photon pediatric brain tumor survivors

This retrospective study seeks to directly compare the long-term health outcomes between two pediatric brain tumor survivor cohorts treated with proton and photon radiotherapy.  This study involves a direct comparison of neurocognitive and health-related quality of life outcomes among brain tumor survivors treated with proton radiation at Massachusetts General Hospital (MGH, Boston, MA, USA) and survivors treated with photon radiation at Emory University/Children’s Healthcare of Atlanta (CHOA, Atlanta, GA, USA).  While radiation is an essential component of curative treatment, it can also contribute to a variety of late adverse health effects. This research will guide future radiation treatment decisions and advocate for access to the radiation technology that maximizes the quality of survivorship in childhood brain tumor patients.

Link to the cancer survivor study

Lay Abstract

Brain tumors are the most common solid cancers affecting children and adolescents. Medulloblastoma and ependymoma are common brain tumors that require treatment with radiation following surgical resection. While radiation is an essential component of curative treatment, radiation to the developing brain contributes to adverse health effects that can impair quality of survivorship. There are two major types of external-beam radiation: photon-based and particle (proton) radiation. Both radiation modalities are alike in their cure rates and biological effectiveness. However, compared with photons, proton radiation has better physical properties that localizes the radiation dose in the tumor target while sparing proximal normal tissues. We need to follow patients for a long time after treatment to determine if the dosimetric advantages of protons translate to an improvement in health outcomes. Supported by the Rising Tide Foundation, our study compares neurocognitive function and quality of life between brain tumor survivors greater than five years out from treatment with protons at Massachusetts General Hospital or with photons at Emory University Hospital. Participants complete a comprehensive clinical evaluation, neurocognitive assessment, and PedsQL survey. DICOM radiation treatment plans are collected to assess dosimetric differences to the brain and its sub-regions. We hypothesize that patients treated with protons will have better neurocognitive outcomes and quality of life scores than patients treated with modern photon radiation due to the ability of protons to spare more normal brain. Our research will guide future treatment decisions and advocate for access to the radiation technology that maximizes quality of life for survivors.