A comparison of the late effects on intellectual and neuropsychologic function of three different CNS "prophylaxis" regimens was conducted in 104 patients treated for childhood acute lymphocytic leukemia. Of the children studied, 33 were randomized to treatment with intrathecal (IT) methotrexate alone, 36 to IT methotrexate plus 2,400 rad cranial irradiation, and 35 to IT methotrexate plus intravenous intermediate dose methotrexate. All patients were in their first (complete) continuous remission, were a minimum of one year post-CNS prophylaxis and had no evidence of CNS disease at the time of evaluation. In contrast to the other two treatment groups, children whose CNS prophylaxis included cranial irradiation attained significantly lower mean Full Scale IQs (P less than .001), performed more poorly on the Wide Range Achievement Test, a measure of school abilities, and exhibited a greater number of difficulties on a variety of other neuropsychologic measures. The poorer performance of the irradiated group was independent of sex of the patient, time since treatment and age at diagnosis. These data suggest that the addition of 2,400 rad cranial irradiation to CNS prophylaxis in ALL puts these children at greater risk for mild global loss in intellectual and neuropsychologic ability.
While there has been increasing recognition of the psychosocial needs of cancer patients, the plight of the patient’s spouse has been less well addressed. As part of an ongoing study in this area, we have developed a counseling manual which defines the parameters of a therapy intervention for cancer patients’ spouses with problematic adjustment. In order to monitor the consistency of the therapy, we have also developed a codable supervision rating sheet, which is the topic of this report. All therapist communications are rated on a three-dimensional format which specifies general content area, level of intervention, and the presence of a focus specific to the therapy. This codable rating sheet is used in a group supervision process. It provides an innovative method to teach and supervise therapy, helps delineate specific elements of therapy judged to be important, and also has implications for psychotherapy research which extend beyond this specific project.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.