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. 2012 Jun 10;30(17):2079-86.
doi: 10.1200/JCO.2011.37.0577. Epub 2012 May 7.

Prospective study of health-related quality of life for children with brain tumors treated with proton radiotherapy

Karen A Kuhlthau  1 , Margaret B Pulsifer, Beow Y Yeap, Dianali Rivera Morales, Jennifer Delahaye, Kristen S Hill, David Ebb, Annah N Abrams, Shannon M Macdonald, Nancy J Tarbell, Torunn I Yock
Affiliations

Prospective study of health-related quality of life for children with brain tumors treated with proton radiotherapy

Karen A Kuhlthau et al. J Clin Oncol. .

Abstract

Purpose: We describe the health-related quality of life (HRQoL) of a cohort of children with brain tumors treated with proton radiotherapy.

Patients and methods: We recruited 142 pediatric patients with brain tumors (age 2 to 18 years) and parents of such patients treated with proton radiation at Massachusetts General Hospital from 2004 to 2010. HRQoL was assessed using the PedsQL core, brain tumor, and cancer modules (range, 0 to 100). Assessments took place during radiation and annually thereafter. We examined correlations of HRQoL with disease, treatment, and cognitive and behavioral data.

Results: Overall reports of HRQoL during treatment were 74.8 and 78.1 for child self-report (CSR) and 67.0 and 74.8 for parent proxy report (PPR) for the core and brain tumor modules, respectively. PPR demonstrated lower HRQoL scores than CSR, but the two were highly correlated. Higher HRQoL scores were significantly associated with Wechsler Full Scale Intelligence Quotient scores (administered via the age-appropriate version) and better scores on two behavioral measures. Disease type also correlated with PPR core total HRQoL score at the beginning of treatment: medulloblastoma or primitive neuroectodermal tumors, 57.8; germ cell tumors, 63.5; ependymoma or high-grade glioma, 69.8; low-grade glioma, 71.5; and other low-grade neoplasms, 78.0 (P = .001). Craniospinal irradiation and chemotherapy were negatively correlated with HRQoL.

Conclusion: This is the first study to our knowledge of HRQoL in a cohort of children with brain tumors treated with proton radiation. This prospective study demonstrates the effect of disease type and intensity of treatment on HRQoL. It further suggests that where CSR is not possible, PPR is appropriate in most circumstances.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
PedsQL total core and tumor scores for the cohort with at least 3 years post-treatment follow-up (n = 43). QOL, quality of life.
Fig 2.
Fig 2.
PedsQL parent proxy total core and tumor scores for the cohort with at least 3 years post-treatment follow-up by radiation type. CSI, craniospinal irradiation.
See this image and copyright information in PMC

Comment in

References

    1. Merchant TE, Kiehna EN, Li C, et al. Radiation dosimetry predicts IQ after conformal radiation therapy in pediatric patients with localized ependymoma. Int J Radiat Oncol Biol Phys. 2005;63:1546–1554. - PubMed
    1. Merchant TE, Kiehna EN, Li C, et al. Modeling radiation dosimetry to predict cognitive outcomes in pediatric patients with CNS embryonal tumors including medulloblastoma. Int J Radiat Oncol Biol Phys. 2006;65:210–221. - PubMed
    1. Merchant TE, Kiehna EN, Miles MA, et al. Acute effects of irradiation on cognition: Changes in attention on a computerized continuous performance test during radiotherapy in pediatric patients with localized primary brain tumors. Int J Radiat Oncol Biol Phys. 2002;53:1271–1278. - PubMed
    1. Hua C, Bass JK, Khan R, et al. Hearing loss after radiotherapy for pediatric brain tumors: Effect of cochlear dose. Int J Radiat Oncol Biol Phys. 2008;72:892–899. - PubMed
    1. MacDonald SM, Safai S, Trofimov A, et al. Proton radiotherapy for childhood ependymoma: Initial clinical outcomes and dose comparisons. Int J Radiat Oncol Biol Phys. 2008;71:979–986. - PubMed

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