NEUROPSYCHOLOGIC EFFECTS OF CHEMOTHERAPY ON CHILDREN WITH CANCER - A LONGITUDINAL-STUDY

Purpose: A prospective study was conducted to assess the effects of ch emotherapy for cancer on children's long-term neuropsychologic status. Patients and Methods: Ninety-nine children who received no cranial th erapy (CRT) completed four annual neuropsychologic assessments. Fifty- one patients received intrathecal (IT) chemotherapy (ITC); 48 received no CNS treatment. These two groups were compared using repeated-measu res analysis of variance on IQ, memory, language, freedom from distrac tibility, academic achievement, executive functions, and fine-motor, p erceptual-motor, and tactile-spatial skills. In addition, 51 of the sa mple of 99 patients had been examined 5 to 11 years after diagnosis. T heir data were analyzed to evaluate the longer-term effects of chemoth erapy. The predictability of demographic and medical variables on neur opsychologic: outcome at 8-year and long-term follow-up study were ass essed using multiple regression techniques. Results: Overall, the effe cts of chemotherapy in the absence of CRT appear to be slight. Patient s who received ITC and intravenous (IV) methotrexate declined slightly on perceptual-motor skills, but were still well within the normal ran ge. Both groups, regardless of treatment, declined on academic achieve ment tests, although not to a statistically significant degree. Age ef fects were found on performance IQ (PIQ) and perceptual-motor skills. Socioeconomic status (SES) correlated with a large number of variables . Sex effects were not significant. Conclusion: The present results ar e largely consistent with previous findings for nonirradiated groups. Treatment effects from ITC are slightly more apparent 5 to 11 years af ter diagnosis than at 9-year follow-up evaluation but this does not co nstitute a clinically meaningful difference. More noticeable ore acade mic declines among all groups, regardless of treatment. (C) 1996 by Am erican Society of Clinical Oncology.