1. The long-term outcome of childhood brain tumours: impact of radiotherapy Dr Sally Davis Registered Clinical Psychologist

3. Increase in incidence

4. NZ amongst highest (3.42/100,000 children)

5. Increased survival rates & quality of survival?

6. Identified cognitive deficits

8. Specific areas of neuropsychological functioning

9. Adaptive functioning (QOL, Coping)

11. Age at diagnosis

12. Time since surgery

13. Duration of symptoms

14. Hydrocephalus

15. Shunt

16. Meningitis

17. Cerebellar mutism syndrome

18. Amount of tumour removed

19. Length of hospital stay

20. Late effects

21. Balance problems

22. Hearing loss

23. Left/right sided weakness

24. Ataxia

25. Alopecia

26. Growth hormone deficiency

27. Vision loss/blurry vision

28. Speech problems

31. low-grade (Grade I and II)

32. slow growing

33. small with distinct borders

34. don’t spread to distant sites

35. easily removed surgically

36. surgery alone is often effective as little risk of further growth

37. Malignant (MB)

38. aggressive (Grade IV)

39. grow rapidly

40. large, lacking distinct borders

41. infiltrate surrounding tissue

42. difficult to surgically remove completely

44. Mean age at dx = 10 yrs

45. Mean no. of yrs post-dx = 17 yrs

46. 19 Pilocytic astrocytoma (PA)

47. Mean age at dx = 12 yrs

48. Mean no. of yrs post-dx = 14 yrs

50. Numerous (15) neuropsychological tests

51. Coping Response Inventory (Moos, 1993)

52. Quality of Life Inventory (Frisch, 1994)

53. Data Analysis

54. T-tests

55. ANOVA (one-way between groups)

56. MANOVA

57. Chi-square tests

59. Data analysis contd.

61. Deficits in MB and PA groups found in:

62. Information Processing Speed

63. Attention

64. Executive functioning

65. Memory

67. Hydrocephalus and shunt ↓ performance

69. ↑ duration of symptoms prior to diagnosis had a negative impact on Learning

71. Self-selection

73. LEAP began July 2006 (Akld, Chch, Wgtn)

74. National paediatric oncology initiative

75. Clinical psychologist and paediatric oncologist