Wengenroth L, Rueegg C S, Michel G, Gianinazzi M E, Essig S, von der Weid N X, Grotzer M, Kuehni Claudia E
Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Switzerland.
Pediatr Blood Cancer. 2015 May;62(5):875-82. doi: 10.1002/pbc.25396. Epub 2015 Feb 2.
Cognitive problems can have a negative effect on a person's education, but little is known about cognitive problems in young childhood cancer survivors (survivors). This study compared cognitive problems between survivors and their siblings, determined if cognitive problems decreased during recent treatment periods and identified characteristics associated with the presence of a cognitive problem in survivors.
As part of the Swiss Childhood Cancer Survivor Study, a questionnaire was sent to all survivors, aged 8-20 years, registered in the Swiss Childhood Cancer Registry, diagnosed at age <16 years, who had survived ≥ 5 years. Parent-reported (aged 8-15 years) and self-reported (aged 16-20 years) cognitive problems (concentration, working speed, memory) were compared between survivors and siblings. Multivariable logistic regression was used to identify characteristics associated with cognitive problems in survivors.
Data from 840 survivors and 247 siblings were analyzed. More often than their siblings, survivors reported problems with concentration (12% vs. 6%; P = 0.020), slow working speed (20% vs. 8%; P = 0.001) or memory (33% vs. 15%; P < 0.001). Survivors from all treatment periods were more likely to report a cognitive problem than were siblings. Survivors of CNS tumors (OR = 2.82 compared to leukemia survivors, P < 0.001) and those who had received cranial irradiation (OR = 2.10, P = 0.010) were most severely affected.
Childhood cancer survivors, even those treated recently (2001-2005), remain at risk to develop cognitive problems, suggesting a need to improve therapies. Survivors with cognitive problems should be given the opportunity to enter special education programs.
认知问题会对一个人的教育产生负面影响，但对于儿童期癌症幸存者（以下简称“幸存者”）的认知问题却知之甚少。本研究比较了幸存者与其兄弟姐妹之间的认知问题，确定了在最近治疗期间认知问题是否有所减少，并确定了与幸存者存在认知问题相关的特征。
作为瑞士儿童癌症幸存者研究的一部分，向所有年龄在8至20岁、在瑞士儿童癌症登记处登记、16岁前确诊且存活≥5年的幸存者发送了一份问卷。比较了幸存者与其兄弟姐妹之间家长报告的（8至15岁）和自我报告的（16至20岁）认知问题（注意力、工作速度、记忆力）。采用多变量逻辑回归来确定与幸存者认知问题相关的特征。
分析了840名幸存者和247名兄弟姐妹的数据。与他们的兄弟姐妹相比，幸存者更常报告注意力问题（12%对6%；P = 0.020）、工作速度慢（20%对8%；P = 0.001）或记忆力问题（33%对15%；P < 0.）。所有治疗期的幸存者比其兄弟姐妹更有可能报告认知问题。中枢神经系统肿瘤幸存者（与白血病幸存者相比，OR = 2.82，P < 0.001）和接受过颅脑照射的幸存者（OR = 2.10，P = 0.010）受影响最为严重。
儿童癌症幸存者，即使是那些近期（2001 - 2005年）接受治疗的幸存者，仍有出现认知问题的风险，这表明需要改进治疗方法。有认知问题的幸存者应获得进入特殊教育项目的机会。
