# White Matter Toxicity and Neurocognitive Outcomes in Pediatric Brain Tumor Patients Treated with Proton Beam Radiation Therapy

> **NIH NIH R01** · BAYLOR COLLEGE OF MEDICINE · 2021 · $771,373

## Abstract

PROJECT SUMMARY/ABSTRACT
 Most children treated for cancer in the US will achieve long-term survival, and survivorship presents unique
challenges for this growing population. Brain tumor survivors are at particular risk for a range of functional
impairments, including cognitive, educational, and social difficulties. Cranial radiation therapy is an essential
lifesaving treatment but is associated with cognitive decline. Proton beam radiation therapy (PBRT) is one of
the most promising recent advances in pediatric brain tumor treatment. The proposed medical advantage of
PBRT lies in the precision of radiation delivery with proton beams, depositing maximum dose to clinical targets
while minimizing radiation to surrounding tissues. By eliminating unnecessary radiation to surrounding healthy
brain tissue, PBRT may spare cognitive functioning better than conventional photon or x-ray irradiation (XRT).
 Using volumetrics and diffusion tensor imaging (DTI), we will examine associations between white matter
(WM) toxicity and neurocognitive outcomes in pediatric brain tumor patients treated with PBRT. Study 1 is a
prospective, longitudinal study of WM change and associated neurocognitive outcomes in pediatric brain tumor
patients treated with PBRT vs. Surgery Only followed from diagnosis through Early Survivorship. Specific aims
include: (1) to compare change in WM volume/integrity over time by treatment group (PBRT vs. Surgery Only
and vs. healthy controls (HCs)), and (2) to examine associations between WM toxicity and neurocognitive test
scores over time. Study 2 is a cross-sectional study of associations between WM and neurocognitive
outcomes during Intermediate Survivorship for pediatric brain tumor survivors treated with PBRT vs. Surgery
Only with the following specific aims: (1) to compare WM volume/integrity in survivors by treatment type (PBRT
vs. Surgery Only and vs. HCs), and (2) to examine associations between WM toxicity and neurocognitive test
scores. Study 3 is a cross-sectional study of WM associations with neurocognitive outcomes during Late
Survivorship for pediatric brain tumor survivors treated with PBRT vs. XRT including the following specific
aims: (1) to compare WM volume/integrity in survivors by treatment group (PBRT vs. XRT and vs. HCs), and
(2) to examine associations between WM toxicity and neurocognitive test scores.
 This proposal is consistent with NCI's objective to “reduce the long-term adverse effects of cancer and its
treatment” in children and to “improve the quality of life for cancer patients, survivors, and their families.”
Neurocognitive late effects lead to significant educational, social, and occupational limitations for many
survivors, greatly affecting their quality of life and functional independence long-term. Research is needed to
determine which treatments are best able to limit the suffering associated with post-treatment neurocognitive
decline. Our results will have clinical value, providing a timely report ...

## Key facts

- **NIH application ID:** 10054959
- **Project number:** 5R01CA221197-04
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** LISA SCHUM KAHALLEY
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $771,373
- **Award type:** 5
- **Project period:** 2017-06-16 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10054959

## Citation

> US National Institutes of Health, RePORTER application 10054959, White Matter Toxicity and Neurocognitive Outcomes in Pediatric Brain Tumor Patients Treated with Proton Beam Radiation Therapy (5R01CA221197-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10054959. Licensed CC0.

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