Nathan Paul C, Patel Sunita K, Dilley Kimberley, Goldsby Robert, Harvey Jeanne, Jacobsen Chad, Kadan-Lottick Nina, McKinley Karen, Millham Anne K, Moore Ida, Okcu M Fatih, Woodman Catherine L, Brouwers Pim, Armstrong F Daniel
Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada.
Arch Pediatr Adolesc Med. 2007 Aug;161(8):798-806. doi: 10.1001/archpedi.161.8.798.
With modern therapies and supportive care, survival of childhood cancer has increased considerably. Patients who have survived cancers involving the central nervous system or who have received therapy toxic to the developing brain are at risk of long-term neurocognitive sequelae. Negative outcomes are observed most frequently in survivors of acute lymphoblastic leukemia and brain tumors. The Children's Oncology Group Long-term Follow-up Guidelines Task Force on Neurocognitive/Behavioral Complications After Childhood Cancer has generated risk-based, exposure-related guidelines designed to direct the follow-up care of survivors of pediatric malignancies based on a comprehensive literature review and expert opinion. This article expands on these guidelines by reviewing the risk factors for the development of neurocognitive sequelae and describing the expected pattern of these disabilities. We herein present recommendations for the screening and management of neurocognitive late effects and outline important areas of school and legal advocacy for survivors with disabilities. Finally, we list resources that can guide patients, their parents, and their medical caregivers as they face the long-term neurocognitive consequences of cancer therapy.
随着现代治疗方法和支持性护理的发展，儿童癌症患者的生存率有了显著提高。患有累及中枢神经系统的癌症或接受过对发育中的大脑有毒性的治疗的患者，有长期神经认知后遗症的风险。急性淋巴细胞白血病和脑肿瘤幸存者中最常观察到不良后果。儿童肿瘤学组儿童癌症后神经认知/行为并发症长期随访指南特别工作组，基于全面的文献综述和专家意见，制定了基于风险、与暴露相关的指南，旨在指导小儿恶性肿瘤幸存者的后续护理。本文通过回顾神经认知后遗症发生的风险因素并描述这些残疾的预期模式，对这些指南进行了扩展。我们在此提出神经认知迟发效应的筛查和管理建议，并概述为残疾幸存者提供学校和法律支持的重要领域。最后，我们列出了一些资源，这些资源可以在患者、其父母及其医疗护理人员面对癌症治疗的长期神经认知后果时为他们提供指导。
