Association of 1800 cGy cranial irradiation with intellectual function in children with acute lymphoblastic leukaemia

doi:10.1016/S0140-6736(94)92997-1

The Lancet

Volume 344, Issue 8917, 23 July 1994, Pages 224-227

https://doi.org/10.1016/S0140-6736(94)92997-1 Get rights and content

Abstract

Summary

Cranial radiation therapy in childhood acute lymphoblastic leukaemia has been associated with adverse neuropsychological effects, such as low intelligence. However, records show that these associations usually occur when the dose of radiation used is 2400 cGy. We investigated whether a lower dose of 1800 cGy had the same adverse effects on long-term survivors and whether high doses of methotrexate but no radiation therapy would have a more beneficial effect.

We evaluated 203 children for six years in a multi-centre European study. The patients were divided into two groups: 129 children treated with 1800 cGy of cranial radiation therapy and 74 children who received high-dose methotrexate but no radiation therapy. We used full scale intelligence quotient, verbal, and performance IQ tests to assess the patient's intelligence. We found a significant decline in full scale intelligence quotient in the irradiated group that increased with the length of time from diagnosis. Younger age at diagnosis was associated with lower full scale intelligence quotient in the radiated group.

Our results indicate that a radiation dose of 1800 cGy can have negative effects on neurocognitive function and we continue to question the benefit of low-dose cranial radiation therapy.

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¹: Participating Investigators are listed at the end of the article. ISPACC is the International Study Group on Psychosocial Aspects of Childhood Cancer

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ArticlesAssociation of 1800 cGy cranial irradiation with intellectual function in children with acute lymphoblastic leukaemia

Abstract

Am J Med

Arch Clin Neuropsychol

Am J Med

Int J Radiat Oncol Biol Phys

Are cognitive and educational development affected by age at which prophylactic therapy is given in acute lymphoblastic leukaemia?

Arch Dis Child

Attentional deficits in long-term survivors of childhood acute lymphoblastic leukemia (ALL)

J Clin Neuropsychol

Neuropsychologic assessment of long-term survivors of childhood leukemia

Am J Pediatr Hematol Oncol

Long-term psychologcial effects of childhood leukemia and its treatment

Am J Pediatr Hematol Oncol

Memory and learning sequelae in long-term survivors of acute lymphoblastic leukemia: association with attention deficit

Am J Pediatr Hematol Oncol

Neuropsychological sequelae of central nervous system prophylaxis in survivors of childhood acute lymphoblastic leukemia

J Consult Clin Psychol

Cognitive functioning in long-term survivors of childhood leukemia: A prospective analysis

J Dev Behav Pediatr

Cognitive function in children with leukemia. Effect of radiation dose and time since irradiation

Cancer

Cognitive effects of cranial irradiation in leukaemia: a survey and meta-analysis

J Child Psychol Psychiatry

Neuropsychologic sequelae in irradiated (1800 rads (r) and 2400 r) and non-irradiated children with acute lymphoblastic leukemia (ALL)

Proc Am Clin Oncol

Comparison of neuropsychologic functioning and clinical indicators of neurotoxicity in long-term survivors of childhood leukemia given cranial radiation or parenteral methotrexate: a prospecxtive study

J Clin Oncol

Articles
Association of 1800 cGy cranial irradiation with intellectual function in children with acute lymphoblastic leukaemia