Preventing Neurocognitive Late Effects in Childhood Cancer Survivors

J Child Neurol. 2008 Oct;23(10):1160-71. doi: 10.1177/0883073808321065.

Abstract

Neurocognitive late effects are common sequelae of cancer in children, especially in those who have undergone treatment for brain tumors or in those receiving prophylactic cranial radiation therapy to treat leukemia. Neurocognitive morbidity in attention, executive functioning, processing speed, working memory, and memory frequently occurs and contributes to declines in intellectual and academic abilities. Oncologists are faced with the challenge of using the most effective, often the most intense, therapy to achieve the primary goal of medical success, balanced with the desire to prevent adverse late effects. Not all children with similar diagnoses and treatment have identical neurocognitive outcomes; some do very poorly and some do well. Attention now turns to the reliable prediction of risk for poor outcomes and then, using risk-adapted therapy, to preserve neurocognitive function. Prevention of late effects through rehabilitative strategies, continuation of school, and pharmacotherapy will be explored.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Age Factors
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Brain / drug effects*
  • Brain / physiopathology
  • Brain / radiation effects*
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / mortality
  • Brain Neoplasms / radiotherapy*
  • Child
  • Cognition Disorders / chemically induced
  • Cognition Disorders / physiopathology
  • Cognition Disorders / prevention & control*
  • Drug Therapy / methods
  • Drug Therapy / trends
  • Drug-Related Side Effects and Adverse Reactions*
  • Humans
  • Iatrogenic Disease / prevention & control
  • Nerve Fibers, Myelinated / drug effects
  • Nerve Fibers, Myelinated / pathology
  • Nerve Fibers, Myelinated / radiation effects
  • Radiotherapy / adverse effects*
  • Radiotherapy / methods
  • Radiotherapy / trends
  • Time