This candidate, Lisa Schum Kahalley, PhD, is an Assistant Professor in the Section of Psychology, Department of Pediatrics, at Baylor College of Medicine, with a secondary appointment in the Texas Children's Cancer Center. The proposed career development award outlines critical mentoring, training, and research experiences to prepare Dr. Kahalley for an independent research program in neurocognitive late effects research. The mentoring committee supporting this application consists of experienced researchers and clinicians in pediatric neuropsychology (Doug Ris, PhD), neuro-oncology (Fatih Okcu, MD, Murali Chintagumpala, MD), and longitudinal statistics (Paras Mehta, PhD). They will oversee this candidate's specialized training in neuropsychology, longitudinal research methods, and scientific writing and grantsmanship to prepare her to transition into neurocognitive outcome research and research independence. The proposed research plan will provide applied experience in these specific areas of focus. Brain tumor survivors are at risk for lasting treatment-related cognitive impairment. Interest in the use of proton beam radiation therapy (PBRT) for treatment of pediatric brain tumor continues to grow as many believe this technique could improve survival rates while also preserving quality of life outcomes. Many herald the clinical potential of PBRT to spare cognitive functioning by minimizing damage to healthy brain tissue without sacrificing disease control. Still, there are no published reports to date of cognitive outcomes following PBRT for pediatric brain tumor. This proposal includes two studies, one cross-sectional and one longitudinal, designed to maximize the empirical yield for this 5-year funding period. Study 1 is a prospective, longitudinal examination of neurocognitive outcomes and changes over time among patients treated for pediatric brain tumors with PBRT versus surgery alone. Study 2 is a cross-sectional comparison of neurocognitive outcomes between survivors of pediatric brain tumor previously treated with PBRT versus conventional radiation therapy. This proposal is consistent with NCI's strategic objectives to improve the quality of life for cancer survivors, promote safe and equitable cancer care, and foster informed decision making. Results will have clinical value, providing a timely initial report of neurocognitive functioning and comparison between treatment modalities that will be a notable addition to the sparse existent literature in PBRT late effects. Remarkable advantages of this research environment will facilitate the successful execution of these studies. In particular, Texas Children's Cancer Center has one of the largest pediatric neuro-oncology programs in the country with access to one of the few proton therapy centers in the US currently open for the treatment of pediatric brain tumor.

Public Health Relevance

Many consider proton beam radiation therapy (PBRT) to be a promising treatment for children suffering from brain tumors as it may preserve cognitive functioning without sacrificing disease control. Currently, there are no published reports of cognitive outcomes for patients treated for pediatric brain tumor with this technology. Ultimately, this line of research is intended to: 1) help physicians and families better understand the effect of PBRT on cognitive functioning to inform treatment decisions, 2) drive intervention development targeted to the cognitive domains found vulnerable to PBRT, and 3) provide functional outcome data to be used toward justifying or reconciling the high cost and access limitations currently associated with PBRT.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Academic/Teacher Award (ATA) (K07)
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Study Section
Subcommittee G - Education (NCI)
Program Officer
Perkins, Susan N
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Baylor College of Medicine
Schools of Medicine
United States
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Antonini, Tanya N; Ris, M Douglas; Grosshans, David R et al. (2017) Attention, processing speed, and executive functioning in pediatric brain tumor survivors treated with proton beam radiation therapy. Radiother Oncol 124:89-97
Willard, Victoria W; Conklin, Heather M; Huang, Lu et al. (2016) Concordance of parent-, teacher- and self-report ratings on the Conners 3 in adolescent survivors of cancer. Psychol Assess 28:1110-8
Kahalley, Lisa S; Winter-Greenberg, Amanda; Stancel, Heather et al. (2016) Utility of the General Ability Index (GAI) and Cognitive Proficiency Index (CPI) with survivors of pediatric brain tumors: Comparison to Full Scale IQ and premorbid IQ estimates. J Clin Exp Neuropsychol 38:1065-76
Kahalley, Lisa S; Ris, M Douglas; Grosshans, David R et al. (2016) Comparing Intelligence Quotient Change After Treatment With Proton Versus Photon Radiation Therapy for Pediatric Brain Tumors. J Clin Oncol 34:1043-9
Bishop, Andrew J; Greenfield, Brad; Mahajan, Anita et al. (2014) Proton beam therapy versus conformal photon radiation therapy for childhood craniopharyngioma: multi-institutional analysis of outcomes, cyst dynamics, and toxicity. Int J Radiat Oncol Biol Phys 90:354-61
Winter, Amanda L; Conklin, Heather M; Tyc, Vida L et al. (2014) Executive function late effects in survivors of pediatric brain tumors and acute lymphoblastic leukemia. J Clin Exp Neuropsychol 36:818-30
Hansen, Jennifer A; Stancel, Heather H; Klesges, Lisa M et al. (2014) Eating behavior and BMI in adolescent survivors of brain tumor and acute lymphoblastic leukemia. J Pediatr Oncol Nurs 31:41-50
Kahalley, Lisa S; Wilson, Stephanie J; Tyc, Vida L et al. (2013) Are the psychological needs of adolescent survivors of pediatric cancer adequately identified and treated? Psychooncology 22:447-58
Kahalley, Lisa S; Conklin, Heather M; Tyc, Vida L et al. (2013) Slower processing speed after treatment for pediatric brain tumor and acute lymphoblastic leukemia. Psychooncology 22:1979-86
Moyer, Katherine H; Willard, Victoria W; Gross, Alan M et al. (2012) The impact of attention on social functioning in survivors of pediatric acute lymphoblastic leukemia and brain tumors. Pediatr Blood Cancer 59:1290-5

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