title: Intellectual and behavioral impairment after chemotherapy and radiotherapy among children with cancer in Iran.
abstract: OBJECTIVE
  It is well established that treatment modalities against cancer have psychosocial and serious medical side effects especially neurologic, learning, and intellectual disorders among children with cancer. The aim of this study was to evaluate the behavioral change specially the effect of chemotherapy and cranial radiotherapy on the development of attention deficit hyperactivity disorder (ADHD) in children with cancer.
  
  
  METHODS
  The children diagnosed with cancer and referred to Mahak Hospital (a well funded charity organization helping children with cancer in Iran) participated in this study. To assess the post treatment behavior, the Conner's Rating Scales (CRS) questionnaire, which its reliability and validity has been well established was administrated by trained interviewer in a two hour sessions to mother or attending nurses of the cases. The relationship between attention deficits, hyperactivity disorder were assessed with different categories of treatment, socio-economic status, age at diagnosis, sex, as well as duration since treatment.
  
  
  RESULTS
  During periods of six months, 30 subjects (16 male and 14 female) were studied and participated in the study. Fifteen cases had both radiotherapy as well as chemotherapy and 15 cases just had chemotherapy as their treatment regiment. The mean Conner's Rating Score (total score of ADHD) were higher among those who received both chemotherapy and radiotherapy compared with those who had just chemotherapy but it was not statistically significant (34.7∓12.6 for just chemotherapy and 39.3∓9.0 for chemo and radiotherapy together). The total Conner's Rating Score was higher among girls compared to boys (mean ∓ standard deviation was 39.8∓9.4 for girls and 33.7∓12 for boys). Duration since treatment, age diagnosis, and mother's level of education had effect in post treatment intellectual capacity and behavioral aspect of patients.
  
  
  CONCLUSIONS
  In the light of dramatic improvement of survival among children with cancer the intellectual and behavioral impairment due to treatment modalities needs serious attention and proper medical management.
authors.affiliation: Dept. of Public Health and Social Medicine, Shaheed Beheshti University of Medical Sciences, Tehran, Iran. Fall1347@yahoo.com
authors.forename: Susan
authors.initials: S
authors.lastname: Parsay
authors.forename: Alireza
authors.initials: A
authors.lastname: Mosavi-Jarrahi
authors.forename: Fariba
authors.initials: F
authors.lastname: Arabgol
authors.forename: Azadeh
authors.initials: A
authors.lastname: Kiomarcy
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology*; D001526:Behavioral Symptoms / Q000209:etiology; D002490:Central Nervous System / Q000187:drug effects / Q000528:radiation effects; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology*; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000009:adverse effects; D004522:Educational Status; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000209:etiology*; D007492:Iran; D008297:Male; D009369:Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D011878:Radiotherapy / Q000009:adverse effects; D011795:Surveys and Questionnaires