Hutchinson Amanda D, Pfeiffer Susan M, Wilson Carlene
aSchool of Psychology, Social Work & Social Policy, University of South Australia Adelaide, SA, Australia bFlinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA, Australia cCancer Council South Australia, Eastwood, SA, Australia.
Curr Opin Support Palliat Care. 2017 Mar;11(1):70-75. doi: 10.1097/SPC.0000000000000258.
To review recent research on cancer-related cognitive impairment (CRCI) in children, including correlational studies and interventions in which outcomes have included cognitive test performance, neuroimaging or academic performance.
Impairments in processing speed, working memory, executive function and attention continue to be demonstrated in survivors of childhood cancers. Children receiving radiation treatment for their cancer demonstrate greater impairment than those who undergo surgery and/or chemotherapy without radiation. However, CRCI still occurs in the absence of radiation treatment, particularly in the domain of attention. Recent neuroimaging studies highlight atypical connectivity of white matter and its associations with cognitive performance. Given impairments in cognitive function and associated neuroanatomical factors, it is not surprising that survivors of childhood cancers experience academic difficulties. However, early intervention may provide one means of improving cognitive and academic outcomes.
Children with cancer are at risk of impairment in the domains of processing speed, attention, working memory and executive function. Those who receive radiation are likely to experience greater CRCI than those who do not receive this treatment. All survivors of childhood cancers should be carefully monitored to provide support and implement evidence-based interventions to ameliorate cognitive late effects.
回顾近期关于儿童癌症相关认知障碍（CRCI）的研究，包括相关性研究以及以认知测试表现、神经影像学或学业成绩为结果的干预措施。
儿童癌症幸存者在处理速度、工作记忆、执行功能和注意力方面持续存在障碍。接受癌症放射治疗的儿童比那些接受手术和/或化疗但未接受放射治疗的儿童表现出更严重的障碍。然而，即使没有放射治疗，CRCI 仍会出现，尤其是在注意力方面。近期的神经影像学研究突出了白质的非典型连接及其与认知表现的关联。鉴于认知功能受损及相关神经解剖学因素，儿童癌症幸存者出现学业困难并不奇怪。然而，早期干预可能是改善认知和学业结果的一种方法。
患癌儿童在处理速度、注意力、工作记忆和执行功能方面存在受损风险。接受放射治疗的儿童比未接受该治疗的儿童更可能经历严重的 CRCI。所有儿童癌症幸存者都应受到密切监测，以提供支持并实施循证干预措施，以改善认知方面的后期影响。
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