Division of Neuropediatrics, Development and Rehabilitation, Children's University Hospital, Inselspital, University of Bern, Bern, Switzerland.
Department of Pediatric Hematology and Oncology, Children's University Hospital, Inselspital, University of Bern, Bern, Switzerland.
Neuropsychol Rehabil. 2022 Jul;32(6):922-945. doi: 10.1080/09602011.2020.1844243. Epub 2020 Nov 19.
Long-term sequelae of cancer and its treatment render childhood cancer (CC) survivors vulnerable to cognitive and behavioural difficulties and likely affect their quality of life (QoL). Our aim was to compare levels of cognition, psychosocial functioning, and health-related QoL of CC survivors to healthy controls and examine the associations between these three domains. Seventy-eight CC survivors (age range = 7-16 years, ≥ one year since cancer treatment) and 56 healthy controls were included. Cognition (i.e., fluid intelligence, executive functions, memory, processing speed, and selective attention), psychosocial functioning, and health-related QoL were assessed using standardized tests and questionnaires. The cognitive performance, parent-reported psychosocial behaviour, and health-related QoL of the CC survivors were within the normative range. However, working memory was significantly poorer in survivors than controls, and visuospatial working memory below the normative range was more commonly observed among survivors than among controls. Processing speed significantly predicted survivors' performance in executive functions. Among survivors, greater peer problems were significantly associated with poorer cognitive functions and health-related QoL. Despite the evidence for good intellectual functioning, which might point towards adequate reserves, in some survivors, domain-specific difficulties may emerge years after cancer relating to psychosocial development and QoL.
癌症及其治疗的长期后遗症使儿童癌症（CC）幸存者易患认知和行为困难，并可能影响他们的生活质量（QoL）。我们的目的是比较 CC 幸存者与健康对照组在认知、心理社会功能和健康相关 QoL 方面的水平，并探讨这三个领域之间的关系。共有 78 名 CC 幸存者（年龄范围为 7-16 岁，癌症治疗后≥1 年）和 56 名健康对照组被纳入研究。使用标准化测试和问卷评估认知（即流体智力、执行功能、记忆、处理速度和选择性注意力）、心理社会功能和健康相关 QoL。CC 幸存者的认知表现、家长报告的心理社会行为和健康相关 QoL 均在正常范围内。然而，与对照组相比，幸存者的工作记忆明显较差，且在幸存者中，比在对照组中更常见的是视觉空间工作记忆低于正常范围。处理速度显著预测了幸存者在执行功能方面的表现。在幸存者中，更多的同伴问题与认知功能和健康相关 QoL 较差显著相关。尽管有证据表明智力功能良好，这可能表明有足够的储备，但在一些幸存者中，与心理社会发展和 QoL 相关的特定领域的困难可能会在癌症治疗多年后出现。
