Guidelines for Complications of Cancer Treatment Vol VIII Part B

activity’ of a person, essentially in terms of degree ofperformance activity regarding movement, eating, cooking,self care, bathing, clothing etc. People with low score are moredependent on others to do their daily living then with thosewith higher scores. Depending upon the performance activity,this evaluation also helps to identify patients, who may requiresupport for daily living and the efficacy of supportive care inimproving their functional activity. ADL is most commonlyassessed by modified Barthel’s Index. However, FIM FAM(Functional independence measurement and functional activitymeasurement) scoring system is a recently being used to assessADL activities as a comprehensive tool and encompassescognitive parameters as well. Activity of daily living (ADL) is a validated method toassess the functional status of a patient. Barthel’s Index (BI) has been used in the evaluation ofefficacy of supportive care or any sort of intervention(radiotherapy or surgery), primarily in elderly patientswith high-grade glioma. BI has shown to improve afterRT in HGG and also in brain metastasis. There are sparse data regarding BI score in pediatriclow grade brain tumour patients treated with RT.However, in our prospective series there was nodeterioration in BI domain scores at 3 year follow up(Jalali 2008).Endocrine functionNeuroendocrine function assessment is done by serumhormone level estimation of different pituitary hypothalamic(PHA) hormone axis. Estimation is done in thyroid hormone(T3, T4, TSH), growth hormone (unstimulated and stimulatedGH), sex hormone (LH, FSH, testosterone), cortisol (cortisol)and prolactin hormone axis (prolactin).349