Williams J M, Davis K S
Cancer Treat Rev. 1986 Jun;13(2):113-27. doi: 10.1016/0305-7372(86)90016-2.
The cognitive sequelae of central nervous system treatments for leukemia have become a major concern as more leukemic children survive the initial consequences of the disease. A review of 28 neuropsychological outcome studies published in the past nine years shows that the preponderance of evidence from the better designed studies suggests that leukemic children who do not suffer overt Central Nervous System (CNS) complications, such as CNS relapse, do not experience significant cognitive deficits as a consequence of their treatment. Also, these studies do not unequivocally suggest that cranial irradiation as a treatment technique results in greater cognitive impairment than treatment without irradiation. Many studies are consistent in finding that leukemic children younger than 8 years of age have a worse outcome than older ones although both groups perform in the average to bright normal range. It is currently difficult to conclude that such differences in intellectual outcome were caused by the CNS treatment alone or other psychosocial aspects of acquiring leukemia. The confusion present in the literature could be greatly reduced by combining the research efforts on the psychosocial aspects of acquiring leukemia with the studies examining neuropsychological outcome.
随着越来越多的白血病患儿在疾病的初始阶段存活下来，中枢神经系统白血病治疗的认知后遗症已成为一个主要问题。对过去九年发表的28项神经心理学结果研究的综述表明，设计较好的研究中的大量证据表明，未出现明显中枢神经系统（CNS）并发症（如CNS复发）的白血病患儿，其治疗后不会出现明显的认知缺陷。此外，这些研究并未明确表明，作为一种治疗技术，头颅放疗比未进行放疗的治疗导致更严重的认知损害。许多研究一致发现，8岁以下的白血病患儿比年龄较大的患儿预后更差，尽管两组的表现都在平均到优秀正常范围内。目前很难得出这样的智力结果差异仅仅是由中枢神经系统治疗还是患白血病的其他社会心理因素导致的结论。将白血病社会心理因素的研究工作与研究神经心理学结果的研究结合起来，可以大大减少文献中存在的混乱。
