Adult Neurobehavioral Late Effects of Pediatric Low Grade Brain Tumors

儿童低度脑肿瘤对成人神经行为的晚期影响

• 批准号: 8257968
• 负责人: M Douglas Ris
• 金额: $ 33.54万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-01 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8257968
• 关键词: 7 year old; 8 year old; Address; Adult; Affect; Age; Aging-Related Process; Astrocytoma; Attention; Brain Neoplasms; Brain Stem Neoplasms; Cerebral Neoplasm; Child; Childhood; Childhood Brain Neoplasm; Childhood Cancer Survivor Study; Chronic; Cognitive aging; Control Groups; Country; Data; Data Adjustments; Data Collection; Data Set; Development; Disease; Early treatment; Education; Employment; Epidemiologic Studies; Equation; Family; Gender; Health; Healthcare Systems; Impairment; Incidence; Income; Investigation; Knowledge; Late Effects; Length; Life; Literature; Location; Long-Term Effects; Malignant Childhood Neoplasm; Malignant Neoplasms; Malignant neoplasm of brain; Measurement; Measures; Medical; Methods; Modeling; Morbidity - disease rate; National Cancer Institute; Nature; Neuropsychological Tests; Occupational; Operative Surgical Procedures; Outcome; Outcome Assessment; Participant; Patients; Population; Positioning Attribute; Proxy; Radiation therapy; Recruitment Activity; Research; Research Infrastructure; Research Personnel; Research Priority; Risk; Sample Size; Sampling; Site; Socioeconomic Status; Subgroup; Sum; Supratentorial; Survivors; Testing; Toxic effect; base; chemotherapy; cognitive reserve; design; disability; follow-up; improved; indexing; mind control; neurobehavioral; neuropsychological; neurotoxic; social; theories; tumor

DESCRIPTION (provided by applicant): Low grade brain tumors of childhood have not received nearly as much attention from late effects researchers as have higher grade/malignant brain tumors, yet they constitute a sizable portion of pediatric brain tumor survivors. The little scientific data available indicates that these patients are at increased risk for sub-optimal outcomes, and that their neurobehavioral late effects profile differs from that found in higher grade brain tumors. This gap in our understanding hampers efforts to address the neurobehavioral liabilities particular to this class of pediatric brain tumor. The objective of this study is to address this major gap in our knowledge by investigating the neuropsychological vulnerabilities and indices of Socioeconomic Status (SES) in adulthood related to childhood low grade brain tumors and their treatment. A landmark epidemiologic study, the Childhood Cancer Survivor Study (CCSS), will be used to identify a sample of 260 patients, now ranging in age from mid-20s to mid-50s, treated for childhood low grade brain tumors as well as controls matched for age, gender, and education of family of origin. An aggressive recruitment/data collection strategy will evaluate participants through 14 testing sites located throughout the country with a battery of neuropsychological tests sensitive to the effects of brain tumors in diverse locations (Specific Aim A). Specific Aim B will investigate disease- and subject-related predictors of outcome. This study improves upon existing research in several respects: (a) It uses an ongoing, highly successful epidemiologic study (CCSS) to identify a large, diverse sample of adults treated as children for low grade brain tumors, (b) A neurobehavioral assessment plan is proposed grounded in previous research that promises to elucidate the neuropsychological vulnerabilities in this population in unprecedented detail, (c) Increased methodological rigor will be achieved through a carefully matched control group, and (d) A remote follow-up design will permit the assessment of adult sequelae of childhood brain tumors, as well as an exploration of how early vulnerabilities might interact with the aging process. The true legacy of childhood cancer spans the entire life, and so the importance of understanding the life trajectories of survivors cannot be over-estimated. A better understanding of the degree and nature of the chronic/remote effects in these patients is critical to the identification for early intervention those at risk, as well as to promote the development of less toxic treatments. PUBLIC HEALTH RELEVANCE: Low grade brain tumors of childhood have not received nearly as much attention from late effects researchers as have higher grade/malignant brain tumors, yet they constitute a sizable portion of pediatric brain tumor survivors. A better understanding of the degree and nature of the chronic/remote effects in patients treated for low grade brain tumors is critical to the identification for early intervention those at risk, as well as to promote the development of less toxic treatments.

描述（由申请人提供）：童年时期的低级脑肿瘤并未受到后期效果研究人员的关注，而不是具有较高的年级/恶性脑肿瘤，但它们构成了小儿脑肿瘤幸存者的相当一部分。可用的很少的科学数据表明，这些患者的次级最佳结局风险增加，并且其神经行为的后期效应与在高级脑肿瘤中发现的效果不同。这一差距在我们的理解中加剧了解决这类小儿脑肿瘤特有的神经行为负债的努力。这项研究的目的是通过研究与儿童低级脑肿瘤及其治疗有关的成年后的社会经济地位（SES）的神经心理学脆弱性和指标来解决我们知识的这一主要差距。一项具有里程碑意义的流行病学研究，即儿童癌症幸存者研究（CCSS），将用于识别260名患者的样本，目前从20岁到50年代中期的年龄不等，对儿童期低级脑肿瘤进行治疗，以及与年龄，性别，性别和起源家族的教育相匹配的控制。一种积极的招聘/数据收集策略将通过全国各地的14个测试地点评估参与者，其中一系列神经心理学测试对不同位置的脑肿瘤的影响敏感（特定的目标A）。特定的目标B将研究结果的疾病和受试者相关的预测指标。这项研究改善了几个方面的现有研究：（a）它使用持续的，非常成功的流行病学研究（CCSS）来确定一个大量的，多样化的成年人样本，被视为低级脑肿瘤的儿童，（b）在先前的研究中，提出了一种基于神经性的研究，该研究旨在提高这种神经心理学的方法，以实现这种态度，以实现这种态度，以实现神经心理学的方法，以实现详细的方法，并在这种研究中进行了良好的方法。将通过一个经过匹配的对照组来实现，（d）远程后续设计将允许评估儿童脑肿瘤的成年后遗症，以及探索早期脆弱性如何与衰老过程相互作用的探索。儿童癌症的真正遗产遍及一生，因此了解幸存者的生命轨迹的重要性不能被过多估计。更好地了解这些患者慢性/远程影响的程度和性质对于早期干预患者的识别至关重要，并促进毒性较小的治疗方法的发展。公共卫生相关性：童年时期的低级脑肿瘤并没有从后期效应的研究人员中受到更高的关注，而较高的脑瘤/恶性脑肿瘤，但它们构成了小儿脑肿瘤幸存者的相当一部分。更好地了解接受低级脑​​肿瘤的患者的慢性/远程影响的程度和性质对于早期干预患者的识别至关重要，并促进毒性较小的治疗方法的发展。