title: An improved methodology for modeling neurobehavioral late-effects of radiotherapy in pediatric brain tumors.
abstract: BACKGROUND
  Technical advances in radiation oncology provide new opportunities to study neurobehavioral outcomes of radiation therapy (RT) in children treated for brain tumors.
  
  
  METHODS
  In this study, we describe an approach to modeling late-effects using integral biologically effective dose (IBED) combined with improved measurement of critical neuropsychological functions.
  
  
  RESULTS
  IBED was found to provide more differentiated information about dose distribution than prescribed dose in five subjects treated for brain tumors. Furthermore, IBED was more closely related than was prescribed dose to specific changes in Attention 2-3 years post-RT.
  
  
  CONCLUSIONS
  Results support the feasibility of this methodology as well as promising preliminary evidence of the relationship of IBED to the construct of Attention. Improved modeling could lead to more refined radiation therapy protocols that preserve critical neuropsychological functions and also provide new insights into the treatment of neurobehavioral sequelae.
authors.affiliation: Department of Pediatrics, University of Cincinnati College of Medicine and Children's Hospital Medical Center, Ohio 45229, USA. douglas.ris@cchmc.org
authors.forename: M Douglas
authors.initials: MD
authors.lastname: Ris
authors.forename: Patricia McDonough
authors.initials: PM
authors.lastname: Ryan
authors.forename: Michael
authors.initials: M
authors.lastname: Lamba
authors.forename: John
authors.initials: J
authors.lastname: Brenemen
authors.forename: Kim
authors.initials: K
authors.lastname: Cecil
authors.forename: Paul
authors.initials: P
authors.lastname: Succop
authors.forename: William
authors.initials: W
authors.lastname: Ball
mesh_terms: D001288:Attention; D001932:Brain Neoplasms / Q000150:complications / Q000523:psychology / Q000532:radiotherapy*; D002648:Child; D004307:Dose-Response Relationship, Radiation; D005500:Follow-Up Studies; D006801:Humans; D008722:Methods; D008954:Models, Biological; D010865:Pilot Projects; D011581:Psychological Tests; D011874:Radiometry; D011878:Radiotherapy / Q000009:adverse effects / Q000523:psychology*; D012062:Relative Biological Effectiveness; D018709:Statistics, Nonparametric; D013997:Time Factors