A B S T R A C T PurposeMethylphenidate (MPH) ameliorates attention problems experienced by some cancer survivors in the short term, but its long-term efficacy is unproven. Patients and MethodsThis study investigates the long-term effectiveness of maintenance doses of MPH in survivors of childhood brain tumors (n ϭ 35) and acute lymphoblastic leukemia (n ϭ 33) participating in a 12-month MPH trial. [CBCL]) were administered at premedication baseline and at the end of the MPH trial while on medication. A cancer control group composed of patients who were not administered MPH (brain tumor ϭ 31 and acute lymphoblastic leukemia ϭ 23) was assessed on the same measures 2 months apart. ResultsFor the MPH group, repeated measures analysis of variance revealed significant improvement in performance on a measure of sustained attention (CPT indices, P Ͻ .05); parent, teacher, and self-report ratings of attention (CRS indices, P Ͻ .05), and parent ratings of social skills or behavioral problems (SSRS and CBCL indices; P Ͻ .05). In contrast, the cancer control group only showed improvement on parent ratings of attention (Conners' Parent Rating Scale indices; P Ͻ .05) and social skills (SSRS and CBCL indices; P Ͻ .05). There was no significant improvement on the academic measure (WIAT) in either group. ConclusionAttention and behavioral benefits of MPH for childhood cancer survivors are maintained across settings over the course of a year. Although academic gains were not identified, MPH may offer benefits in academic areas not assessed.

Purpose To determine whether the addition of advanced-practice nurse (APN) telephone counseling to a printed survivorship care plan (SCP) significantly increases the proportion of at-risk survivors who complete cardiomyopathy screening. Patients and Methods Survivors age ≥ 25 years participating in the Childhood Cancer Survivor Study who received cardiotoxic therapy and reported no history of cardiomyopathy screening in the previous 5 years were eligible for enrollment. The 472 participants (mean age, 40.1 years; range, 25.0 to 59.0; 53.3% women) were randomly assigned to either standard care, consisting of an SCP summarizing cancer treatment and cardiac health screening recommendations (n = 234), or standard care plus two APN telephone counseling sessions (n = 238). The primary outcome—completion of cardiomyopathy screening within 1 year—was validated by medical records and compared between the two arms using adjusted relative risks (RRs) with 95% CIs. Results Participants in the standard and APN counseling groups were not statistically different by demographic or clinical characteristics. At the time of 1-year follow-up, 107 (52.2%) of 205 survivors in the APN group completed screening compared with 46 (22.3%) of 206 survivors in the non-APN group (P < .001). With adjustment for sex, age (< 30 v ≥ 30 years), and Children's Oncology Group–recommended screening frequency group (annual, 2 years, or 5 years), survivors in the APN group were > 2× more likely than those in the control group to complete the recommended cardiomyopathy screening (RR, 2.31; 95% CI, 1.74 to 3.07). Conclusion The addition of telephone counseling to an SCP with cardiac health screening recommendations increases cardiomyopathy screening in at-risk survivors.