Neurobehavioural sequelae following cranial irradiation and chemotherapy in children: an analysis of risk factors.
Neurobehavioural deficits are commonly reported following treatment for childhood cancers. This study examined the impact of cranial irradiation (CRT) and chemotherapy in children, aiming to identify factors detrimental to long-term outcome. The study compared survivors of acute lymphoblastic leukemia (ALL), treated with CRT and chemotherapy (CRT group: n = 100), survivors of cancers treated with chemotherapy only (n = 50) and healthy controls (n = 100) for intelligence, academic achievement, information processing, learning, and executive function. CRT and chemotherapy in combination were associated with reduced intelligence, educational skill, immediate memory, processing speed, and executive function. Children treated with chemotherapy alone exhibited subtle information processing deficits. Within the CRT group, younger age at treatment was predictive of deficits in non-verbal ability, educational skills and executive functions. High dose CRT was associated with poorer information processing and lower arithmetic ability.
Department of Psychology, University of Melbourne, Parkville, Victoria, Australia.
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Anderson
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Godber
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Smibert
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Ekert
D000124:Achievement; D000208:Acute Disease; D000293:Adolescent; D000367:Age Factors; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects / Q000528:radiation effects*; D016022:Case-Control Studies; D002648:Child; D002652:Child Behavior / Q000187:drug effects / Q000528:radiation effects*; D016371:Cranial Irradiation; D005260:Female; D005544:Forecasting; D006801:Humans; D007360:Intelligence / Q000187:drug effects / Q000528:radiation effects; D007858:Learning / Q000187:drug effects / Q000528:radiation effects; D007951:Leukemia, Myeloid / Q000188:drug therapy; D008297:Male; D008433:Mathematics; D008568:Memory / Q000187:drug effects / Q000528:radiation effects; D008606:Mental Processes / Q000187:drug effects / Q000528:radiation effects; D009369:Neoplasms / Q000188:drug therapy; D009633:Nonverbal Communication; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000532:radiotherapy; D011597:Psychomotor Performance / Q000187:drug effects / Q000528:radiation effects; D011879:Radiotherapy Dosage; D012307:Risk Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents