PEDIATRICS Vol. 75 No. 4 April 1985, pp. 745-753
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Neuropsychological Sequelae of Childhood Cancer in Long-Term Survivors

Donna R. Copeland PhD1, Jack M. Fletcher PhD1, Betty Pfefferbaum-Levine MD1, Norman Jaffe MD1, Hubert Ried MD1, and Moshe Maor MD1

1 From the Department of Pediatrics, The University of Texas M. D. Anderson Hospital and Tumor Institute, Houston

In order to assess the effects of various cancer treatments on neuropsychological functioning, 74 long-term survivors of childhood cancer were examined. A comprehensive battery of tests was administered to two CNS treatment groups (irradiated and nonirradiated leukemia and lymphoma patients) and a control group (solid tumor and Hodgkin disease patients receiving no CNS treatment). The CNS-irradiated group obtained lower scores than the other two groups, with significant differences in visual-motor and fine motor skills, spatial memory, and arithmetic achievement resulting in significant differences in IQ scores (VIQ, PIQ, FSIQ). The results are discussed in relation to: (1) the effects of CNS irradiation on cognitive development; (2) the specificity of these effects; and (3) the relationship of age at diagnosis to treatment effects. It is concluded that although there is a general lowering of scores after CNS irradiation, the effect is most pronounced for nonlanguage skills. Age at diagnosis was less important than the type of treatment, with CNS irradiation reducing performance regardless of when cancer was diagnosed. There were indications that children with any type of cancer diagnosed before age 5 years are more likely to have some cognitive difficulties.

Key Words: children • cancer • neuropsychological functioning

Submitted on December 5, 1983
Accepted on May 9, 1984


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