Neuropsychological sequelae of childhood cancer in long-term survivors.
In order to assess the effects of various cancer treatments on neuropsychological functioning, 74 long-term survivors of childhood cancer were examined. A comprehensive battery of tests was administered to two CNS treatment groups (irradiated and nonirradiated leukemia and lymphoma patients) and a control group (solid tumor and Hodgkin disease patients receiving no CNS treatment). The CNS-irradiated group obtained lower scores than the other two groups, with significant differences in visual-motor and fine motor skills, spatial memory, and arithmetic achievement resulting in significant differences in IQ scores (VIQ, PIQ, FSIQ). The results are discussed in relation to: (1) the effects of CNS irradiation on cognitive development; (2) the specificity of these effects; and (3) the relationship of age at diagnosis to treatment effects. It is concluded that although there is a general lowering of scores after CNS irradiation, the effect is most pronounced for nonlanguage skills. Age at diagnosis was less important than the type of treatment, with CNS irradiation reducing performance regardless of when cancer was diagnosed. There were indications that children with any type of cancer diagnosed before age 5 years are more likely to have some cognitive difficulties.
D000367:Age Factors; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001921:Brain / Q000000981:diagnostic imaging / Q000528:radiation effects; D001932:Brain Neoplasms / Q000517:prevention & control* / Q000556:secondary; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D007278:Injections, Spinal; D007361:Intelligence Tests; D007807:Language Tests; D007858:Learning; D007938:Leukemia / Q000188:drug therapy / Q000523:psychology / Q000532:radiotherapy; D008223:Lymphoma / Q000188:drug therapy / Q000523:psychology / Q000532:radiotherapy; D009369:Neoplasms / Q000523:psychology*; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents