title: Neuropsychologic effects of chemotherapy on children with cancer: a longitudinal study.
abstract: OBJECTIVE
  A prospective study was conducted to assess the effects of chemotherapy for cancer on children's long-term neuropsychologic status.
  
  
  METHODS
  Ninety-nine children who received no cranial radiation therapy (CRT) completed four annual neuropsychologic assessments. Fifty-one patients received intrathecal (IT) chemotherapy (ITC); 48 received no CNS treatment. These two groups were compared using repeated-measures analysis of variance on IQ, memory, language, freedom from distractibility, academic achievement, executive functions, and fine-motor, perceptual-motor, and tactile-spatial skills. In addition, 51 of the sample of 99 patients had been examined 5 to 11 years after diagnosis. Their data were analyzed to evaluate the longer-term effects of chemotherapy. The predictability of demographic and medical variables on neuropsychologic outcome at 3-year and long-term follow-up study were assessed using multiple regression techniques.
  
  
  RESULTS
  Overall, the effects of chemotherapy in the absence of CRT appear to be slight. Patients who received ITC and intravenous (IV) methotrexate declined slightly on perceptual-motor skills, but were still well within the normal range. Both groups, regardless of treatment, declined on academic achievement tests, although not to a statistically significant degree. Age effects were found on performance IQ (PIQ) and perceptual-motor skills. Socioeconomic status (SES) correlated with a large number of variables. Sex effects were not significant.
  
  
  CONCLUSIONS
  The present results are largely consistent with previous findings for nonirradiated groups. Treatment effects from ITC are slightly more apparent 5 to 11 years after diagnosis than at 3-year follow-up evaluation but this does not constitute a clinically meaningful difference. More noticeable are academic declines among all groups, regardless of treatment.
authors.affiliation: University of Texas M.D. Anderson Cancer Center, Houston 77030, USA. dcopeland@pedi01.mda.uth.tmc.edu
authors.forename: D R
authors.initials: DR
authors.lastname: Copeland
authors.forename: B D
authors.initials: BD
authors.lastname: Moore
authors.forename: D J
authors.initials: DJ
authors.lastname: Francis
authors.forename: N
authors.initials: N
authors.lastname: Jaffe
authors.forename: S J
authors.initials: SJ
authors.lastname: Culbert
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology / Q000627:therapeutic use*; D001288:Attention / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007360:Intelligence / Q000187:drug effects*; D008297:Male; D009043:Motor Activity / Q000187:drug effects*; D009369:Neoplasms / Q000188:drug therapy / Q000523:psychology*; D009484:Neuropsychology; D010465:Perception / Q000187:drug effects*; D011446:Prospective Studies; D012044:Regression Analysis; D012959:Socioeconomic Factors