Guidelines for identification of, advocacy for, and intervention in neurocognitive problems in survivors of childhood cancer: a report from the Children's Oncology Group.
With modern therapies and supportive care, survival of childhood cancer has increased considerably. Patients who have survived cancers involving the central nervous system or who have received therapy toxic to the developing brain are at risk of long-term neurocognitive sequelae. Negative outcomes are observed most frequently in survivors of acute lymphoblastic leukemia and brain tumors. The Children's Oncology Group Long-term Follow-up Guidelines Task Force on Neurocognitive/Behavioral Complications After Childhood Cancer has generated risk-based, exposure-related guidelines designed to direct the follow-up care of survivors of pediatric malignancies based on a comprehensive literature review and expert opinion. This article expands on these guidelines by reviewing the risk factors for the development of neurocognitive sequelae and describing the expected pattern of these disabilities. We herein present recommendations for the screening and management of neurocognitive late effects and outline important areas of school and legal advocacy for survivors with disabilities. Finally, we list resources that can guide patients, their parents, and their medical caregivers as they face the long-term neurocognitive consequences of cancer therapy.
Nathan
Paul C
PC
Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada. paul.nathan@sickkids.ca
Patel
Sunita K
SK
Dilley
Kimberley
K
Goldsby
Robert
R
Harvey
Jeanne
J
Jacobsen
Chad
C
Kadan-Lottick
Nina
N
McKinley
Karen
K
Millham
Anne K
AK
Moore
Ida
I
Okcu
M Fatih
MF
Woodman
Catherine L
CL
Brouwers
Pim
P
Armstrong
F Daniel
FD
D002648:Child; D002651:Child Advocacy; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D003266:Continuity of Patient Care; D006801:Humans; D008495:Medical Oncology / Q000592:standards*; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D009483:Neuropsychological Tests; D010344:Patient Advocacy; D010372:Pediatrics / Q000592:standards*; D017410:Practice Guidelines as Topic; D018787:Radiation Oncology / Q000592:standards*; D017741:Survivors / Q000523:psychology*; D014481:United States