RADIOTHERAPY IN THE TREATMENT OF LOW-GRADE ASTROCYTOMAS .2. THE PHYSICAL AND COGNITIVE SEQUELAE

The purpose of the present study was to define the late effects, both physical and psychological, of treating low-grade astrocytomas with ra diotherapy. Fifty patients, half of whom received radiotherapy, underw ent an assessment of neurological and neuropsychological function. The re was no difference in neurological function between the two groups. The radiotherapy recipients, including those with cerebellar tumours, performed significantly worse on measures of intelligence and informat ion processing. In addition, there was a greater incidence of special education needs in the irradiated group. We conclude that children wit h low-grade astrocytomas who receive radiotherapy have no greater neur ological deficit but that the use of radiotherapy carries a penalty in terms of long-term cognitive function and confirmed the findings of m any previous reports that supratentorial irradiation is detrimental. M ore surprisingly, it has been demonstrated that local field irradiatio n to the posterior fossa can also produce significant cognitive impair ment.