Torunn I Yock1, Sundeep Bhat2, Jackie Szymonifka3, Beow Y Yeap3, Jennifer Delahaye4, Sarah S Donaldson5, Shannon M MacDonald6, Margaret B Pulsifer7, Kristen S Hill4, Thomas F DeLaney6, David Ebb8, Mary Huang8, Nancy J Tarbell6, Paul Graham Fisher9, Karen A Kuhlthau10. 1. Department of Radiation Oncology, Massachusetts General Hospital, Proton Center, Boston, United States. Electronic address: tyock@partners.org. 2. Department of Emergency Medicine, Kaiser Permanente, Santa Clara Medical Center, United States. 3. Biostatistics Unit, Department of Medicine, Massachusetts General Hospital, Boston, United States. 4. Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Boston, United States. 5. Stanford Cancer Center, Department of Radiation Oncology, United States. 6. Department of Radiation Oncology, Massachusetts General Hospital, Proton Center, Boston, United States. 7. Department of Psychiatry, Massachusetts General Hospital, Boston, United States. 8. Department of Pediatric Oncology, Massachusetts General Hospital, Proton Center, Boston, United States. 9. Stanford University Medical Center, Department of Neurology, Palo Alto, United States. 10. Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Department of Pediatrics, Harvard Medical School, Boston, United States.
Abstract
BACKGROUND: Radiotherapy can impair Health Related Quality of Life (HRQoL) in survivors of childhood brain tumors, but proton radiotherapy (PRT) may mitigate this effect. This study compares HRQoL in PRT and photon (XRT) pediatric brain tumor survivors. METHODS: HRQoL data were prospectively collected on PRT-treated patients aged 2-18 treated at Massachusetts General Hospital (MGH). Cross-sectional PedsQL data from XRT treated Lucile Packard Children's Hospital (LPCH) patients provided the comparison data. RESULTS: Parent proxy HRQoL scores were reported at 3 years for the PRT cohort (PRT-C) and 2.9 years (median) for the XRT cohort (XRT-C). The total core HRQoL score for the PRT-C, XRT-C, and normative population differed from one another and was 75.9, 65.4 and 80.9 respectively (p=0.002; p=0.024; p<0.001). The PRT-C scored 10.3 and 10.5 points higher than the XRT-C in the physical (PhSD) and psychosocial (PsSD) summary domains of the total core score (TCS, p=0.015; p=0.001). The PRT-C showed no difference in PhSD compared with the normative population, but scored 6.1 points less in the PsSD (p=0.003). Compared to healthy controls, the XRT-C scored lower in all domains (p<0.001). CONCLUSIONS: The HRQoL of pediatric brain tumor survivors treated with PRT compare favorably to those treated with XRT and similar to healthy controls in the PhSD.
BACKGROUND: Radiotherapy can impair Health Related Quality of Life (HRQoL) in survivors of childhood brain tumors, but proton radiotherapy (PRT) may mitigate this effect. This study compares HRQoL in PRT and photon (XRT) pediatric brain tumor survivors. METHODS: HRQoL data were prospectively collected on PRT-treated patients aged 2-18 treated at Massachusetts General Hospital (MGH). Cross-sectional PedsQL data from XRT treated Lucile Packard Children's Hospital (LPCH) patients provided the comparison data. RESULTS: Parent proxy HRQoL scores were reported at 3 years for the PRT cohort (PRT-C) and 2.9 years (median) for the XRT cohort (XRT-C). The total core HRQoL score for the PRT-C, XRT-C, and normative population differed from one another and was 75.9, 65.4 and 80.9 respectively (p=0.002; p=0.024; p<0.001). The PRT-C scored 10.3 and 10.5 points higher than the XRT-C in the physical (PhSD) and psychosocial (PsSD) summary domains of the total core score (TCS, p=0.015; p=0.001). The PRT-C showed no difference in PhSD compared with the normative population, but scored 6.1 points less in the PsSD (p=0.003). Compared to healthy controls, the XRT-C scored lower in all domains (p<0.001). CONCLUSIONS: The HRQoL of pediatric brain tumor survivors treated with PRT compare favorably to those treated with XRT and similar to healthy controls in the PhSD.
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