Change in Neurocognitive Functioning After Treatment With Cranial Radiation in Childhood Brenda J. Spiegler, Eric Bouffet, Mark L. Greenberg, James T. Rutka, Donald J. Mabbott From the Departments of Psychology, Pediatrics, and Surgery, and Divisions of Hematology/Oncology and Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada Address reprint requests to Donald Mabbott, PhD, Paediatric Brain Tumor Program, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada; e-mail: donald.mabbott@ sickkids.ca PURPOSE: To evaluate the pattern of stability and change over time across multiple domains of neurocognitive function in radiated survivors of posterior fossa (PF) tumors. PATIENTS AND METHODS: Thirty-four children (25 males) treated for malignant PF tumors were observed with serial clinical neuropsychologic assessments. Thirty patients were treated for medulloblastoma and four patients were treated for ependymoma. Twelve patients were treated with reduced-dose and 21 patients were treated with standard-dose cranial radiation. All patients received an additional boost to the PF. One patient was treated with PF radiation only. Standardized neuropsychologic tests were administered at different times after diagnosis for each child. The rate of change in scores was determined using a mixed model regression. RESULTS: Results showed a 2- to 4-point decline per year in intelligence scores. For our relatively young sample, intellectual function declined quickly in the first few years after treatment, and then more gradually. Significant declines in visual-motor integration, visual memory, verbal fluency, and executive functioning were also documented. No decline was evident for verbal memory and receptive vocabulary. CONCLUSION: Cranial radiation is associated with a decline in multiple neurocognitive domains, with a few notable exceptions. Our results must be interpreted in the context of common limitations of clinical research, including patient variability, changes in test versions, small sample size, and clinical referral bias. Journal of Clinical Oncology, Vol 22, No 4 (February 15), 2004: pp. 706-713 DOI: 10.1200/JCO.2004.05.186 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.