Survivors of childhood brain tumors more likely to report impaired neurocognition

Survivors of childhood central nervous system malignancies had a higher risk for neurocognitive impairment that was associated with lower socioeconomic achievements in adulthood, according to recently published data.

As part of the Childhood Cancer Survivor Study being conducted at nine major medical centers, researchers assessed neurocognitive functioning in 785 adult survivors of childhood CNS malignancies and compared them with 5,870 survivors of non-CNS malignancies and 379 siblings without cancer. They assessed neurocognitive functioning using a 25-item neurocognitive questionnaire that considered four factors, including task efficiency, emotional regulation, organization and memory. The researchers noted that in a small number of cases, CNS cancer survivors had assistance completing the questionnaire.

Survivors of CNS malignancy reported greater neurocognitive impairment in all factors compared with those who survived non-CNS cancers and with siblings (P<.01). They reported the greatest impairments for memory and task efficiency.

More than half of CNS cancer survivors reported problems with at least one task efficiency problem, which the researchers wrote was three times greater than the sibling group.

Survivors of CNS malignancy who reported medical complications, including hearing deficits, paralysis and cerebrovascular incidents, had a greater likelihood of reporting deficits on each of the test factors.

As assessed by multiple linear regression analyses, those CNS cancer survivors with lower scores demonstrated lower educational achievement (P<.01), lower household income (P<.001), less full-time employment (P<.001) and fewer marriages (P<.001).

“This underscores the need for continued attention to mitigating the long-term negative effects of CNS malignancies and their treatment,” the researchers wrote.

Ellenberg L. Neuropsychology. 2009;23:705-717.