Children who have undergone radiation treatment for brain cancer tend to have lower grades in school than their healthy peers, investigators in Finland have found. Still, most survivors in their study group completed the ninth grade at the appropriate age.
Though other studies have reported overall educational achievements of brain tumour survivors, this is the first to assess the effect of the cancer and radiation therapy on grades in school and in specific subjects, Dr Paivi M Lahteenmaki and colleagues point out in the journal Neurology.
Lahteenmaki, from Turku University, and associates gathered data from national registries for 300 cases of childhood cancer and 1473 healthy subjects of similar age, sex, and residential area.
Patients had been diagnosed with cancer before age 16, were born between 1974 and 1986, and were alive at their 16th birthday.
The analyses showed several variables that affected subjects' grades, including gender, age at diagnosis, and exposure to brain radiation.
The effects of radiation therapy were more pronounced among boys whose radiation therapy was administered when they were older than 7 years old, the authors report, whereas girls were more affected by radiation therapy prior to school age.
The overall average academic grade was lower in patients than comparison subjects. Boys' grades were lower than those of girls, which was also seen among healthy children.
However, girls' grades were impacted more by the disease and its treatment than were the boys'.
The greatest difficulty was studying a foreign language, the report indicates. Lahteenmaki and associates observed that effects were more moderate for mathematics and physical education, whereas the differences were minor for classes taught in the mother tongue.
Despite their lower grades, 94 per cent of brain tumour survivors completed the ninth grade of Finnish comprehensive school at the usual age of 16 years.
"Children diagnosed with brain tumours, even low-grade ones treated with surgery only, should be monitored closely during and after treatment to identify early signs of learning disabilities," Lahteenmaki's group concludes, "and to maximize intervention strategies for the successful completion of scholastic goals."
SOURCE: Neurology, July 17, 2007.