Lessons in pediatric neuropsycho-oncology: What we have learned since Johnny Gunther

Abstract

Objective: This article provides a commentary on the progression of research over the last six decades into the neurobehavioral outcomes of children treated for intracranial tumors. Methods: Published studies and literature reviews are surveyed, with illustrations from the author's ongoing longitudinal study. Results: Research on late effects in pediatric brain tumors continues to increase in both volume and quality. Samples are larger and more differentiated, scope of outcome measurement has increased, and more powerful developmental research designs are being used. Particularly promising recent developments are described, including research on: imaging-behavior relationships, improved modeling of dose-volume heterogeneity in radiation therapy, improved late effects measurement, and treatments for neurobehavioral sequelae. Conclusions: There is now a large body of scientific evidence of increasing sophistication regarding the outcomes of patients receiving the most toxic treatments. It is argued that more research into the neuropsychological effects associated with "benign" tumors of childhood is needed. © The Author 2007. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved.