Prospective Assessment of Quality of Life (QOL) in Pediatric Patients Treated With Radiation Therapy for Brain Tumors and Non-central Nervous System (Non-CNS) Malignancies

In recent years, remarkable advances in medical oncology, surgery, and radiology have allowed
for increasing cure rates for childhood malignancies. This success has led to an emerging
understanding of the kinds of effects that treatments can have on the pediatric population
and how such effects can influence pediatric cancer survivor's functioning and quality of
life. It has become tremendously important to assess the long-term complications due to
therapy in this growing sector of survivors and to tailor our treatments so as to minimize
these late effects.

The Investigators at MGH are committed to improving the delivery of radiotherapy to our
patients and improving the outcome for these patients. MGH has an on-site cyclotron for
proton radiotherapy in order to provide the most advanced care for patients in need. Proton
therapy possesses a clinical advantage over standard photon therapy in that its optimal dose
distribution delivers the bulk of radiation to the tumor site. This method spares the
greatest volume of normal tissue, resulting in decreased short-term and long-term morbidity.

Through open pediatric protocols for patients treated with proton radiotherapy, the
investigators aim to define and report the acute and late effects associated with treatment.

The investigators also treat a number of patients off-protocol with both proton and photon
radiotherapy, and are interested in reporting these patients' QOL outcomes in conjunction
with other clinical data that may be pertinent to the site of tumor treatment. This research
is significant in that it will allow us to delineate the positive and negative effects of
radiation treatment on patients' QOL, highlighting points of success and exposing areas that
are in need of improvement. Such knowledge will be used to improve the experience of
pediatric cancer survivors in the future.

The aims of this study are: 1) to prospectively collect and report the QOL outcomes in
patients treated with radiotherapy and 2) to correlate the QOL data with pertinent clinical
information.