Impact of Racial Disparities on Survival for Children and Adolescents: A Gamma Knife Retrospective Population-Based Study
Central nervous system (CNS) tumors are the second most common cancer in terms of incidence and mortality for children age 0-14. Treatment for brain tumors in children and adolescents is changing rapidly. For radiotherapy, the use of stereotactic radiosurgery (SRS) has helped improve prognosis for patients with brain cancer while attempting to maximize quality of life. SRS allows the delivery of high dose radiation to a target tissue with rapid dose drop off to the adjacent normal, healthy tissue. Gamma Knife (Elekta AB, Stockholm, Sweden), CyberKnife (Accuray, Sunnyvale, CA, USA), and gantry-based linear accelerator (LINAC) are the more common devices used in SRS. Developed in 1968, the Gamma Knife uses a concentrated radiation dose from 201 intersecting radiation beams that converge on an identified tumor (usually less than 3cm). The Gamma Knife is used to treat benign slow growing tumors including meningiomas, acoustic neuromas, pituitary adenomas, craniopharyngiomas, low-grade astrocytomas; primary or recurrent malignant brain tumors including glioblastoma and anaplastic astrocytoma; solitary and multiple brain metastases; and arteriovenous malformations. For children, the use of radiosurgery for inoperable brain tumors may present an opportunity to improve outcomes and minimize toxicity. The Surveillance, Epidemiology, and End Results program (SEER) collects and publishes cancer incidence, survival and treatment data from population-based cancer registries; SEER captures ~98% of incident cancers and the 18 tumor registries encompass nearly 30% of the US population.
Using SEER, we will identify children and adolescents diagnosed with a brain tumor, investigate whether outcomes have been improving over the past two decades, and how often radiosurgery is used as treatment. As an exploratory analysis, we will investigate the socioeconomic and racial factors associated with radiosurgery treatment of CNS cancers to hypothesize whether there is equal access to this resource intensive therapy.
Mentored by Dr. James Yu
Yale University, New Haven, CT