Neuropsychological functioning in childhood cancer survivors following cranial radiotherapy - results from a long-term follow-up clinic

Treatment of malignant childhood posterior fossa tumors (CPFT) often includes surgical resection and craniospinal radiotherapy (CSI). Nasopharyngeal tumors in childhood (CNPHT) are often treated with surgery and radiotherapy (RT), leading to incidental brain irradiation. RT to the developing brain i...

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Bibliographic Details
Published in:Neurocase 2022-03, Vol.28 (2), p.163-172
Main Authors: Rydén, Isabelle, Fernström, Erik, Lannering, Birgitta, Kalm, Marie, Blomstrand, Malin, Hellström, Per, Björk-Eriksson, Thomas, Jarfelt, Marianne
Format: Article
Language:English
Subjects:
adult survivors
boost volume
Brain cancer
brain neoplasm
brain-tumors
Childhood
Childhood cancer survivors
Children
cognition
Cognitive ability
Complications
Fatigue
head
medulloblastoma
nasopharyngeal neoplasms
neck
Neuropsychology
Neurosciences
Neurosciences & Neurology
Neurovetenskaper
posterior-fossa tumors
Psychiatry
psychological distress
Psychology
Psykiatri
Psykologi
Quality of life
Radiation therapy
radiotherapy
risk-factors
Throat cancer
Tumors
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Summary:Treatment of malignant childhood posterior fossa tumors (CPFT) often includes surgical resection and craniospinal radiotherapy (CSI). Nasopharyngeal tumors in childhood (CNPHT) are often treated with surgery and radiotherapy (RT), leading to incidental brain irradiation. RT to the developing brain is associated with risks for cognitive impairments. We studied cognitive functioning, health-related quality of life (HRQOL), fatigue, and psychological distress, in adult survivors of CPFT and CNPHT, representing two groups, which had received high and low radiation dose-exposure to the brain, respectively. Cognitive tests were used to compare CPFT (n = 12) and CNPHT (n = 7) survivors to matched healthy controls (n = 28). HRQOL data was compared to the general population (GP) (n = 1415-1459). Average follow-up was 23 (CPFT) and 19 years (CNPHT). CPFT survivors had significant deficits in all cognitive domains. CNPHT survivors showed results below the control group but differed statistically only on one executive test. HRQOL-ratings indicated that both groups had similar self-reported cognitive problems. CPFT survivors reported more emotional problems and fatigue. Anxiety was seen in both CPFT and CNPHT survivors. This study confirmed long-term cognitive sequelae after RT in adult survivors of CPFT,and possible RT-induced cognitive deficits in adult CNPHT survivors.
ISSN:1355-4794
1465-3656
1362-4970
DOI:10.1080/13554794.2022.2049825