In a new study led by the Yale Cancer Center, researchers report that many childhood cancer survivors are receiving systemic therapies linked to cognitive effects and chronic health problems that can affect long-term cognitive outcomes with downstream effects on education, employment, and health problems. income. The results are published online today in the Journal of Clinical Oncology (JCO).
“Cognitive outcomes in childhood cancer survivors are largely underexposed,” said Nina S. Kadan-Lottick, MD, MSPH, associate professor of pediatrics (hematology / oncology) and leader of the Disease Aligned Research Team (DART) for pediatric cancer at Yale Cancer Center and senior author of the study. “In this study, we aimed to examine cognitive functioning after specific extracranial solid tumor and lymphoma diagnoses to discuss possible associated risk factors and highlight research gaps to help provide clinical guidance for affected survivors.”
Researchers examined previous studies examining long-term (> 2 years without therapy and / or 5 years from diagnosis) cognitive outcomes in childhood survivors (diagnosed <21 years) extracranial solid tumors and lymphomas with at least 10 patients within the diagnostic subcategory back to 1990 The studies suggested that survivors of osteosarcoma, neuroblastoma, Wilms tumor, non-Hodgkin lymphoma, Hodgkin lymphoma, and Langerhans cell histiocytosis are at increased risk of cognitive impairment. Comorbid health problems have often been associated with cognition. For pediatric survivors of Ewing's sarcoma, retinoblastoma, and soft tissue sarcomas, the data was less conclusive for similar disorders.
“Given the older age in the diagnosis of many extracranial solid tumors and lymphomas in children, as well as toxicities associated with certain therapies, we concluded that in addition to surveillance, patients may benefit from vocational education, occupational therapy, physical therapy and / or hearing or visual rehabilitation for cognitive problems, ”added Kadan-Lottick.“ However, larger prospective studies are needed that can better delineate the severity of cognitive impairment, contributing risk factors, and effective interventions to reduce impairment. ”
The study’s lead author is Rebecca Foster, PhD. Other authors of the study include Daniel J. Zheng, MD, and Kelli L. Netson-Amore, PhD.