Abstract 840

Brain tumors are the second most common type of cancer occurring in children. Advances in the medical treatment of these tumors have resulted in increased survival and improved prognoses. These tumors, their resection, and radiation and/or chemotherapy can have significant impact on normal brain tissue as manifested by defects in cognition. This current study was directed to investigate the variables of tumor site, treatments received, and patient factors on neurocognitive and neuropsychological functioning. Patients (n=55) treated for childhood brain tumors were divided into three groups based on tumor site. Subjects were six years of age and older. All patients received a comprehensive neuropsychological test battery. Tumor grouping was designated by blind review of neuroradiological evaluations (i.e. researcher had no knowledge of neuropsychological test results). The three groups were significantly different in time off treatment (longer for infra group) but not on any other descriptive characteristics. Supra- (n=24) and infratentorial tumors (n=17) were associated with neuropsychological impairment in many areas, although memory was relatively intact in the infra group while language functions were relatively impaired in the supra group. The diencephalic tumor patients (n=14) were remarkably intact in most areas except for delayed memory retention. The effects of irradiation to the brain appeared to be most pronounced in nondominant hemisphere functions, attention/concentration and, at high doses, in all areas of academic achievement. Overall, patients treated for supratentorial tumors experience greater impairment. The groups were not significantly different on indices of psychological adjustment. These results are most relevant to the first year off treatment and these late effects of cranial irradiation may not be fully realized at this point post therapy.