LATE EFFECTS OF CHILDHOOD CANCER: COGNITIVE AND PSYCHOSOCIAL DEVELOPMENT.
Contributors: University of California, San Francisco.
Published: 1985
Number of pages: 205
Subjects: Health Sciences, Nursing.
Description: The purpose of this research was twofold: to determine if CNS prophylaxis for acute lymphoblastic leukemia (ALL) has late effects on cognitive functioning; and to determine if childhood cancer and its treatment has late effects on psychosocial functioning. The study tested the vulnerable period hypothesis in relation to the delayed effects of CNS therapy on the developing brain and in relation to the long-term sequelae of cancer on selected aspects of psychosocial development.

Thirty-five subjects who were at least five years from the diagnosis of childhood cancer participated in this study of cognitive and psychosocial late effects. The subjects were divided into four groups to determine the effects of treatment (systemic therapy with and without CNS prophylaxis) and age at time of treatment (before or after 60 months) on cognitive functioning. Age at time of treatment was the major comparison variable in relation to psychosocial functioning.

The hypothesis that CNS prophylaxis has a significant adverse effect on subsequent cognitive functioning was supported consistently on the dependent measures of general intelligence, academic achievement, visuospatial skills, and visual memory. Subjects treated before the age of 60 months performed worse than those who received the same therapy after this age, supporting the hypothesis that the brain is particularly vulnerable to biologic insults during periods of rapid development.

Analysis of the Deasy-Spinetta Behavioral Questionnaire (DSBQ) for cancer subjects suggested that the type of malignancy did not have a significant effect on psychosocial functioning. The hypothesis that age at time of treatment would have a significant effect was not supported.

Comparisons between the cancer survivors and the controls on the DSBQ Total and Cognitive Subscale scores demonstrated that those treated previously for leukemia were functioning below their healthy peers on both measures. This was not the case with subjects who had survived a solid tumor.

The findings suggest that CNS prophylaxis results in deficits in cognitive functioning which are more severe during vulnerable periods of brain development, and that children treated for ALL may also experience long-term psychosocial problems. The results underscore the need for ongoing evaluation of the child receiving cancer therapy in order to detect and minimize late effects.
Notes: Source: Dissertation Abstracts International, Volume: 46-11, Section: B, page: 3783.

Thesis (D.N.S.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1985.

School code: 0034.