Quality of life in pediatric brain tumor patients treated with proton therapy: a review of the literature

ABSTRACT Introduction: Primary brain tumors are the most common solid cancer of childhood, and treatment involves surgery, chemotherapy, or radiation therapy. Although radiation therapy is an effective treatment, the effect on children in the long term is concerning. Proton beam therapy (PBT) exploits the favorable characteristics of charged particle beams to deliver less radiation dose to normal tissues. As cancer treatment improves, and as children live longer, attention has turned to maximizing health-related quality of life. Areas covered: Within this review, we summarize the literature on proton beam therapy and health-related quality of life instruments and the trials that have evaluated the impact of radiation therapy on health-related quality of life (HRQOL). Expert commentary: In order to justify the use of PBT, it will be important to quantify the HRQOL benefit in clinical trials. However, unexpected toxicities like brainstem necrosis may reduce the gain in HRQOL benefits of PBT. Since HRQOL is a new area of research with few published papers to date, we believe more detailed and precise patient-reported outcomes collected prospectively with long-term follow-up are essential to further our understanding of acute and long-term sequelae associated with PBT.