Guidelines for Complications of Cancer Treatment Vol VIII Part B

number of patients. Cognition was poorer in some specificdomains than others. We are collecting prospective follow-updata to show the further impact of various RT techniques onthese parameters.4. Neuropsychologic functioning of survivors ofchildhood medulloblastoma randomized to receiveconventional or reduced-dose craniospinalirradiation: a Pediatric Oncology Group study.Mulhern RK, Kepner JL, Thomas PR, Armstrong FD,Friedman HS, Kun LE. J Clin Oncol. 1998;16(5):1723-8.PURPOSE: The purpose of this study was to test the hypothesisthat survivors of medulloblastoma who were younger atdiagnosis and those who received standard-dose cranialirradiation (SRT) of 36 Gy would have a lower performanceon standardized tests of cognitive function and achievementthan children who were older and those treated with reduceddosecranial irradiation (RRT) of 23.4 Gy.PATIENTS AND METHODS: Eligible patients had beentreated on Pediatric Oncology Group (POG) study 8631 forlow-risk medulloblastoma that randomized patients to receiveRRT or SRT after surgical resection. Those who were aliveand free of progressive disease 6.1 to 9.9 years fromcompletion of treatment were eligible for this study. Of the 35eligible patients, 22 patients (13 SRT, nine RRT) participatedin a battery of tests that included intellectual and academicdevelopment as well as ratings of health-related quality of life.RESULTS: Patients were stratified by treatment group (SRTv RRT) and into younger (Y) and older (O) groups by themedian age at diagnosis (8.85 years), which resulted in fourgroups that we hypothesized would show neuropsychologictest scores in the following order: Y/SRT less than Y/RRTless than O/SRT less than O/RRT. Evidence to support the359