INTELLECTUAL, EDUCATIONAL, AND BEHAVIORAL SEQUELAE AFTER CRANIAL IRRADIATION AND CHEMOTHERAPY

Cognitive and educational sequelae are inconsistently reported in chil dren treated with cranial irradiation for acute lymphoblastic leukaemi a. This study investigated differences in these skills after cranial i rradiation, controlling the effects of chemotherapy and psychosocial f actors. Three groups were evaluated: 100 children diagnosed with acute lymphoblastic leukaemia and treated with cranial irradiation and chem otherapy; 50 children diagnosed with acute lymphoblastic leukaemia or other cancers and treated with chemotherapy alone; and a healthy contr ol group of 100 children. Children in the clinical groups stopped trea tment at least two years before evaluation and had no history of relap se. Children were aged between 7 and 16 at the time of assessment, Eva luation included cognitive, educational, and behavioural measures. Ana lyses found that children receiving cranial irradiation and chemothera py performed more poorly than non-irradiated groups on intellectual an d educational tests, with verbal and attentional deficits most pronoun ced. Children receiving chemotherapy alone performed similarly to cont rols, suggesting such treatment is not associated with adverse neurobe havioural sequelae.