Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Sci Rep. 2019 May 13;9(1):7290. doi: 10.1038/s41598-019-43874-4.
Long-term childhood cancer survivors' (CCS) quality of life can be impacted by late effects such as cognitive difficulties. Especially survivors of CNS tumors are assumed to be at risk, but reports of cognitive tests in CCS with survival times >25 years are scarce. We assessed planning ability, a capacity closely related to fluid intelligence, using the Tower of London. We compared 122 CNS tumor survivors, 829 survivors of other cancers (drawn from a register-based sample of adult long-term CCS), and 215 healthy controls (using sex-specific one-way ANOVAs and t-tests). Associations of CCS' planning ability with medical and psychosocial factors were investigated with a hierarchical linear regression analysis. Mean planning ability did not differ between CCS and controls. However, female CNS tumor survivors performed worse than female survivors of other cancers and female controls. CNS tumor survivors of both sexes had a lower socioeconomic status, and fewer of them had achieved high education than other survivors. In the regression analysis, lower status and anxiety symptoms were associated with poor planning, suggesting possible mediators of effects of disease and treatment. The results indicate the necessity to contextualize test results, and to include cognitive and psychological assessments into aftercare.
长期儿童癌症幸存者（CCS）的生活质量可能会受到认知困难等晚期效应的影响。特别是中枢神经系统肿瘤幸存者被认为存在风险，但对于生存时间超过 25 年的 CCS 患者的认知测试报告却很少。我们使用伦敦塔评估了计划能力，这是一种与流体智力密切相关的能力。我们比较了 122 名中枢神经系统肿瘤幸存者、829 名其他癌症幸存者（从基于登记的成年长期 CCS 幸存者样本中抽取）和 215 名健康对照组（使用性别特异性单向方差分析和 t 检验）。使用分层线性回归分析调查了 CCS 计划能力与医疗和心理社会因素的关联。CCS 和对照组的计划能力平均值没有差异。然而，女性中枢神经系统肿瘤幸存者的表现不如女性其他癌症幸存者和女性对照组。两性的中枢神经系统肿瘤幸存者社会经济地位较低，接受高等教育的比例也低于其他幸存者。在回归分析中，较低的社会地位和焦虑症状与较差的计划能力相关，这表明疾病和治疗的影响可能存在中介因素。结果表明有必要对测试结果进行背景化，并将认知和心理评估纳入后续护理中。
