Adult survivors of childhood central nervous system (CNS) malignancies are at high risk for long-term
morbidity and late mortality. However, patterns of late mortality, the long-term risks of subsequent neo-
plasms and debilitating medical conditions, and sociodemographic outcomes have not been comprehen-
sively characterized for individual diagnostic and treatment groups.
We collected information on treatment, mortality, chronic medical conditions, and neurocognitive func-
tioning of adult 5-year survivors of CNS malignancies diagnosed between 1970 and 1986 within the
Childhood Cancer Survivor Study. Using competing risk framework, we calculated cumulative mortality
according to cause of death and cumulative incidence of subsequent neoplasms according to exposure
and dose of cranial radiation therapy (RT). Neurocognitive impairment and socioeconomic outcomes were
assessed with respect to dose of CNS radiotherapy to specific brain regions. Cumulative incidence of
chronic medical conditions was compared between survivors and siblings using Cox regression models.
All tests of statistical significance were two-sided.
Survivors of childhood CNS malignancies are at high risk for late mortality and for developing subsequent
neoplasms and chronic medical conditions. Care providers should be informed of these risks so they can
provide risk-directed care and develop screening guidelines.