title: Absence of synergistic effects of CNS treatments on neuropsychologic test performance among children.
abstract: Three hypotheses are proposed to account for neurobehavioral impairments following treatment with cranial radiation therapy (CRT) and intrathecal (IT) chemotherapy: CNS treatments exert a synergistic effect (A x B), an additive effect (A + B), or a single-agent effect (A or B). Eighty-five long-term survivors of non-CNS cancers aged 6 to 16 years were classified into groups on the basis of CNS treatments: CRT-IT (n = 25), CRT-No IT (n = 11), No CRT-IT (n = 24), and No CRT-No IT (n = 25). Study I findings did not provide support for synergistic mechanisms; nonorthogonal analysis of variance showed interaction effects (CRT x IT) restricted to tactile-perceptual speed. However, main effects were significant for a single agent (CRT) across a wide range of measures. General intelligence, academic achievement, verbal knowledge and reasoning, and perceptual-motor abilities were found to be significantly lower among CRT-treated groups. Study II findings provided additional support for the role of CRT; Pearson correlations within the CRT-No IT group indicated significant negative associations between CRT dose estimates for cortical regions and perceptual-motor abilities.
authors.affiliation: Department of Psychology, Williamsport Hospital and Medical Center, PA.
authors.forename: R E
authors.initials: RE
authors.lastname: Dowell
authors.forename: D R
authors.initials: DR
authors.lastname: Copeland
authors.forename: D J
authors.initials: DJ
authors.lastname: Francis
authors.forename: J M
authors.initials: JM
authors.lastname: Fletcher
authors.forename: M
authors.initials: M
authors.lastname: Stovall
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D003071:Cognition / Q000187:drug effects / Q000528:radiation effects; D003131:Combined Modality Therapy; D016371:Cranial Irradiation / Q000009:adverse effects*; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D009447:Neuroblastoma / Q000628:therapy; D009483:Neuropsychological Tests; D012208:Rhabdomyosarcoma / Q000628:therapy; D013964:Thyroid Neoplasms / Q000628:therapy