Patterns of neuropsychological deficits in children with medulloblastoma according to craniospatial irradiation doses

This study aimed to analyse the relationship between supratentorial irradia tion dose and the intellectual outcome in 36 children (aged between 5 and 1 5 years) treated for medulloblastoma. The supratentorial radiation dose was reduced to 25 Gy in 23 children and given at the standard dose, 35 Gy, in 13 other children. Neuropsychological evaluation was performed at a mean of 4.3 years (SD 4.7 years) after radiotherapy. The supratentorial radiation dose was the principal risk factor associated with impaired intellectual ou tcome, Verbal fluency, immediate word list recall, block design, and fine m otricity of the dominant hand were significantly lower in children irradiat ed at the standard doses than in those irradiated at reduced doses. These f indings suggest that the dose of radiotherapy applied to the brain strongly influences later verbal and non-verbal skills in children with medulloblas toma, This should be taken into account in treatment planning and in rehabi litation programs.