An improved methodology for modeling neurobehavioral late-effects of radiotherapy in pediatric brain tumors

BACKGROUND: Technical advances in radiation oncology provide new opportunities to study neurobehavioral outcomes of radiation therapy (RT) in children treated for brain tumors. METHODS: In this study, we describe an approach to modeling late-effects using integral biologically effective dose (IBED) combined with improved measurement of critical neuropsychological functions. RESULTS: IBED was found to provide more differentiated information about dose distribution than prescribed dose in five subjects treated for brain tumors. Furthermore, IBED was more closely related than was prescribed dose to specific changes in Attention 2-3 years post-RT. CONCLUSIONS: Results support the feasibility of this methodology as well as promising preliminary evidence of the relationship of IBED to the construct of Attention. Improved modeling could lead to more refined radiation therapy protocols that preserve critical neuropsychological functions and also provide new insights into the treatment of neurobehavioral sequelae.