Conclusions
Regardless of radiation modality, pediatric brain tumor survivors are at risk for long-term social difficulties, with perceived friendship quality and peer acceptance being areas of particular vulnerability. Survivors are also at risk for cognitive late effects, and those with weaknesses in verbal memory may be at higher risk for peer relationship challenges. Treatment variables such as time since radiation, hydrocephalus/shunt placement, and tumor diameter may prove more influential for long-term social functioning than radiation modality, although further investigation is needed. Overall, survivors will benefit from continued monitoring of cognitive and social functioning over the course of survivorship. It is hoped that further inquiry into cognitive and clinical predictors of social outcomes will inform interventions to support survivor social adjustment and overall quality of life.