{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:30:47Z","timestamp":1791214247607,"version":"4.1.0"},"reference-count":28,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"17","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2003,9,1]]},"abstract":"<jats:p>Purpose: To describe the neurologic and neurosensory deficits in children with brain tumors (BTs), compare incidence of these deficits with that of a sibling control group, and evaluate the factors associated with the development of these deficits.<\/jats:p>\n                  <jats:p>Patients and Methods: Detailed questionnaires were completed on 1,607 patients diagnosed between 1970 and 1986 with a primary CNS tumor. Neurosensory and neurologic dysfunctions were assessed and results compared with those of a sibling control group. Medical records on all patients were abstracted, including radiotherapy dose and volume.<\/jats:p>\n                  <jats:p>Results: Seventeen percent of patients developed neurosensory impairment. Relative to the sibling comparison group, patients surviving BTs were at elevated risk for hearing impairments (relative risk [RR], 17.3; P = &lt; .0001), legal blindness in one or both eyes (RR, 14.8; P = &lt; .0001), cataracts (RR, 11.9; P = &lt; .0001), and double vision (RR, 8.8; P = &lt; .0001). Radiation exposure greater than 50 Gy to the posterior fossa was associated with a higher likelihood of developing any hearing impairment. Coordination and motor control problems were reported in 49% and 26%, respectively, of survivors. Children receiving at least 50 Gy to the frontal brain regions had a moderately elevated risk for motor problems (RR, 2.0; P &lt; .05). Seizure disorders were reported in 25% of patients, including 6.5% who had a late first occurrence. Radiation dose of 30 Gy or more to any cortical segment of the brain was associated with a two-fold elevated risk for a late seizure disorder.<\/jats:p>\n                  <jats:p>Conclusion: Children surviving BTs are at significant risk for both early and late neurologic or neurosensory sequelae. These sequelae need to be prospectively monitored.<\/jats:p>","DOI":"10.1200\/jco.2003.01.202","type":"journal-article","created":{"date-parts":[[2003,8,28]],"date-time":"2003-08-28T17:22:07Z","timestamp":1062091327000},"page":"3255-3261","source":"Crossref","is-referenced-by-count":302,"title":["Long-Term Neurologic and Neurosensory Sequelae in Adult Survivors of a Childhood Brain Tumor: Childhood Cancer Survivor Study"],"prefix":"10.1200","volume":"21","author":[{"given":"Roger J.","family":"Packer","sequence":"first","affiliation":[{"name":"From the Departments of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children\u2019s National Medical Center, Departments of Neurology and Pediatrics, The George Washington University, Washington, DC; Department of Pediatrics, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford; Department of Pediatrics, David Gelfen School of Medicine at the University of California, Department of Pediatrics, Los Angeles, CA;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James G.","family":"Gurney","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children\u2019s National Medical Center, Departments of Neurology and Pediatrics, The George Washington University, Washington, DC; Department of Pediatrics, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford; Department of Pediatrics, David Gelfen School of Medicine at the University of California, Department of Pediatrics, Los Angeles, CA;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy A.","family":"Punyko","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children\u2019s National Medical Center, Departments of Neurology and Pediatrics, The George Washington University, Washington, DC; Department of Pediatrics, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford; Department of Pediatrics, David Gelfen School of Medicine at the University of California, Department of Pediatrics, Los Angeles, CA;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah S.","family":"Donaldson","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children\u2019s National Medical Center, Departments of Neurology and Pediatrics, The George Washington University, Washington, DC; Department of Pediatrics, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford; Department of Pediatrics, David Gelfen School of Medicine at the University of California, Department of Pediatrics, Los Angeles, CA;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"Inskip","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children\u2019s National Medical Center, Departments of Neurology and Pediatrics, The George Washington University, Washington, DC; Department of Pediatrics, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford; Department of Pediatrics, David Gelfen School of Medicine at the University of California, Department of Pediatrics, Los Angeles, CA;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilyn","family":"Stovall","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children\u2019s National Medical Center, Departments of Neurology and Pediatrics, The George Washington University, Washington, DC; Department of Pediatrics, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford; Department of Pediatrics, David Gelfen School of Medicine at the University of California, Department of Pediatrics, Los Angeles, CA;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Yasui","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children\u2019s National Medical Center, Departments of Neurology and Pediatrics, The George Washington University, Washington, DC; Department of Pediatrics, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford; Department of Pediatrics, David Gelfen School of Medicine at the University of California, Department of Pediatrics, Los Angeles, CA;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann C.","family":"Mertens","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children\u2019s National Medical Center, Departments of Neurology and Pediatrics, The George Washington University, Washington, DC; Department of Pediatrics, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford; Department of Pediatrics, David Gelfen School of Medicine at the University of California, Department of Pediatrics, Los Angeles, CA;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles A.","family":"Sklar","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children\u2019s National Medical Center, Departments of Neurology and Pediatrics, The George Washington University, Washington, DC; Department of Pediatrics, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford; Department of Pediatrics, David Gelfen School of Medicine at the University of California, Department of Pediatrics, Los Angeles, CA;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Stacy","family":"Nicholson","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children\u2019s National Medical Center, Departments of Neurology and Pediatrics, The George Washington University, Washington, DC; Department of Pediatrics, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford; Department of Pediatrics, David Gelfen School of Medicine at the University of California, Department of Pediatrics, Los Angeles, CA;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lonnie K.","family":"Zeltzer","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children\u2019s National Medical Center, Departments of Neurology and Pediatrics, The George Washington University, Washington, DC; Department of Pediatrics, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford; Department of Pediatrics, David Gelfen School of Medicine at the University of California, Department of Pediatrics, Los Angeles, CA;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P.","family":"Neglia","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children\u2019s National Medical Center, Departments of Neurology and Pediatrics, The George Washington University, Washington, DC; Department of Pediatrics, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford; Department of Pediatrics, David Gelfen School of Medicine at the University of California, Department of Pediatrics, Los Angeles, CA;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie L.","family":"Robison","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children\u2019s National Medical Center, Departments of Neurology and Pediatrics, The George Washington University, Washington, DC; Department of Pediatrics, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford; Department of Pediatrics, David Gelfen School of Medicine at the University of California, Department of Pediatrics, Los Angeles, CA;..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"R3","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1990.72.4.0572"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410280615"},{"key":"R5","unstructured":"Packer RJ, Deutsch M, Thomas PRM, et al: What constitutes standard therapy for children older than 3 years of age with non-disseminated medulloblastoma. 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