Proton-Beam Radiation Therapy and Health-Related Quality of Life in Children With CNS Tumors

tion, TX) in 142 children with CNS tumors who were treated with proton-beam radiotherapy. During a 3-year period, HRQoL, as reportedbybothchildrenandparents,improvedtolevelsclosetothose reported for healthy children, and above those reported for children with other chronic illnesses. The authors also found that poorer HRQoL was associated with poorer performance on measures of intellectual function, adding more evidence for the association between neurocognitive late effects and HRQoL. This study 17 provides support for the possibility that reducing neurotoxicity and associated late neurocognitive effects will result in better long-term HRQoL. There are caveats to this observation. The study did not assess the trends in HRQoL for children treated with CRTusingmoreconventionalphoton-beamradiotherapy,soaheadto-headcomparisonofbenefitisnotpossible.Inaddition,assessment ofneurocognitivefunctionwasnotperformedinasystematicmanner for the population, so the association between neurocognitive function and HRQoL remains speculative. Nonetheless, after decades of seeing the HRQoL of children treated for CNS tumors adversely affected, these results can only be viewed as positive. As with any report of first-in-the-field findings, there are always aspects that could be improved on in subsequent studies. Notable amongtheseisthattheonlychildrenabletoparticipateinthestudyby Kuhlthau et al 17 were those who lived in the area close to the proton