Research Aims: A disparity in patient outcomes exists in the treatment of cancer in developed and developing countries. Contributing to this disparity are the relatively limited resources in developing countries, including technology, expertise, and training of clinical personnel. Our long-term research goal is to reduce the probability of late effects from cancer radiotherapy by reducing the level of disparity between children in developed and developing countries. Because proton therapy reduces exposure to normal tissues, we believe that using it rather than photon therapy for regional craniospinal irradiation of childhood cancer of the central nervous system (CNS) will significantly reduce the risk of late effects. However, we expect that proton therapy carries no advantage in conformal irradiation of localized brain cancer. Therefore, it is our hypothesis that a statistically significant disparity between developed and developing countries exists in pediatric patient outcomes following regional radiotherapy and that this disparity is not significant for localized treatment. Testing this hypothesis requires knowledge of the radiation exposures to organs at risk from the best available treatment modalities in developing and developed countries. The following specific aims will test the hypothesis: (1) In a virtual clinical trial, quantify the disparity in outcomes of children receiving regional (craniospinal) irradiation for CNS cancer according to the standard of care in a developing country versus that in a developed country. (2) In a virtual clinical trial, quantify the disparity in outcomes of children receiving three-dimensional conformal radiotherapy for a localized brain tumor according to the standard of care in a developing country versus that in a developed country. Career Development Aims: My short-term career development goal is to receive training as an international research scientist. The environments in the supporting institutions offer a unique opportunity to accomplish this. The University of Texas M. D. Anderson Cancer Center is a premier cancer center with state-of-the-art radiotherapy technologies. The American University of Beirut Medical Center is a leading specialty hospital treating cancers in a developing country in the Middle East and an internationally recognized research institution. Under the mentorship of established leaders in radiation oncology research, this work seeks to build on the partnership between the two institutions, sharpen my skills in addressing a global health problem, and prepare me to become an independent cancer researcher in an international context. I will accomplish this by enhancing my clinical research skills, improving my competitiveness for future research funding, and forging a network of collaborators in the Middle East.

Public Health Relevance

Childhood cancer is a global health problem that affects nations of every socioeconomic status. Radiotherapy is a vital component of treatment for most childhood cancers;however, radiotherapy is known to cause detrimental late effects that impact the length and quality of life of childhood cancer survivors. We propose to quantify for children with localized and regional brain cancers the disparity between outcomes of radiotherapy in a developing country versus a developed country.

Agency
National Institute of Health (NIH)
Institute
Fogarty International Center (FIC)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01TW008409-04
Application #
8463644
Study Section
Special Emphasis Panel (ZRG1-ICP2-B (51))
Program Officer
Jessup, Christine
Project Start
2010-05-01
Project End
2014-04-30
Budget Start
2013-05-01
Budget End
2014-04-30
Support Year
4
Fiscal Year
2013
Total Cost
$72,586
Indirect Cost
$4,808
Name
University of Texas MD Anderson Cancer Center
Department
Radiation-Diagnostic/Oncology
Type
Other Domestic Higher Education
DUNS #
800772139
City
Houston
State
TX
Country
United States
Zip Code
77030
Perez-Andujar, A; Newhauser, W D; Taddei, P J et al. (2013) The predicted relative risk of premature ovarian failure for three radiotherapy modalities in a girl receiving craniospinal irradiation. Phys Med Biol 58:3107-23
Zhang, Rui; Howell, Rebecca M; Homann, Kenneth et al. (2013) Predicted risks of radiogenic cardiac toxicity in two pediatric patients undergoing photon or proton radiotherapy. Radiat Oncol 8:184
Taddei, Phillip J; Jalbout, Wassim; Howell, Rebecca M et al. (2013) Analytical model for out-of-field dose in photon craniospinal irradiation. Phys Med Biol 58:7463-79
Zhang, Rui; Howell, Rebecca M; Giebeler, Annelise et al. (2013) Comparison of risk of radiogenic second cancer following photon and proton craniospinal irradiation for a pediatric medulloblastoma patient. Phys Med Biol 58:807-23
Wang, Xiaochun; Amos, Richard A; Zhang, Xiaodong et al. (2011) External-beam accelerated partial breast irradiation using multiple proton beam configurations. Int J Radiat Oncol Biol Phys 80:1464-72
Yepes, Pablo P; Mirkovic, Dragan; Taddei, Phillip J (2010) A GPU implementation of a track-repeating algorithm for proton radiotherapy dose calculations. Phys Med Biol 55:7107-20
Taddei, Phillip J; Mahajan, Anita; Mirkovic, Dragan et al. (2010) Predicted risks of second malignant neoplasm incidence and mortality due to secondary neutrons in a girl and boy receiving proton craniospinal irradiation. Phys Med Biol 55:7067-80
Howell, Rebecca M; Scarboro, Sarah B; Taddei, Phillip J et al. (2010) Methodology for determining doses to in-field, out-of-field and partially in-field organs for late effects studies in photon radiotherapy. Phys Med Biol 55:7009-23
Zhang, Rui; Perez-Andujar, Angelica; Fontenot, Jonas D et al. (2010) An analytic model of neutron ambient dose equivalent and equivalent dose for proton radiotherapy. Phys Med Biol 55:6975-85
Taddei, Phillip J; Chell, Erik; Hansen, Steven et al. (2010) Assessment of targeting accuracy of a low-energy stereotactic radiosurgery treatment for age-related macular degeneration. Phys Med Biol 55:7037-54

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