title: Quality of life outcomes in proton and photon treated pediatric brain tumor survivors.
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.
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital, Proton Center, Boston, United States. Electronic address: tyock@partners.org.
authors.forename: Torunn I
authors.initials: TI
authors.lastname: Yock
authors.affiliation: Department of Emergency Medicine, Kaiser Permanente, Santa Clara Medical Center, United States.
authors.forename: Sundeep
authors.initials: S
authors.lastname: Bhat
authors.affiliation: Biostatistics Unit, Department of Medicine, Massachusetts General Hospital, Boston, United States.
authors.forename: Jackie
authors.initials: J
authors.lastname: Szymonifka
authors.affiliation: Biostatistics Unit, Department of Medicine, Massachusetts General Hospital, Boston, United States.
authors.forename: Beow Y
authors.initials: BY
authors.lastname: Yeap
authors.affiliation: Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Boston, United States.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Delahaye
authors.affiliation: Stanford Cancer Center, Department of Radiation Oncology, United States.
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Donaldson
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital, Proton Center, Boston, United States.
authors.forename: Shannon M
authors.initials: SM
authors.lastname: MacDonald
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, United States.
authors.forename: Margaret B
authors.initials: MB
authors.lastname: Pulsifer
authors.affiliation: Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Boston, United States.
authors.forename: Kristen S
authors.initials: KS
authors.lastname: Hill
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital, Proton Center, Boston, United States.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: DeLaney
authors.affiliation: Department of Pediatric Oncology, Massachusetts General Hospital, Proton Center, Boston, United States.
authors.forename: David
authors.initials: D
authors.lastname: Ebb
authors.affiliation: Department of Pediatric Oncology, Massachusetts General Hospital, Proton Center, Boston, United States.
authors.forename: Mary
authors.initials: M
authors.lastname: Huang
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital, Proton Center, Boston, United States.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Tarbell
authors.affiliation: Stanford University Medical Center, Department of Neurology, Palo Alto, United States.
authors.forename: Paul Graham
authors.initials: PG
authors.lastname: Fisher
authors.affiliation: Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Department of Pediatrics, Harvard Medical School, Boston, United States.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Kuhlthau
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000523:psychology / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D017785:Photons / Q000627:therapeutic use*; D011446:Prospective Studies; D061766:Proton Therapy; D011788:Quality of Life; D017741:Survivors / Q000523:psychology; D016896:Treatment Outcome
keywords: Late effects; Outcomes; Pediatric brain tumors; Proton radiotherapy; QoL