Seizures' impact on cognition and quality of life in childhood cancer survivors

Phillips, Nicholas S.; Khan, Raja B.; Li, Chenghong; Salehabadi, Sedigheh Mirzaei; Brinkman, Tara M.; Srivastava, Deokumar; Robison, Leslie L.; Hudson, Melissa M.; Krull, Kevin R.; Sadighi, Zsila

doi:10.1002/cncr.33879

Cited by 12 publications

(6 citation statements)

References 49 publications

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“…Adult survivors of childhood cancer who reported fatigue were more likely to have cognitive impairment compared with those without fatigue . Other characteristics associated with cognitive impairment include sleep disruption, cardiopulmonary disease and endocrine dysfunction, higher cumulative anesthesia exposure, exercise intolerance, severe hearing impairment and seizures, and missed school instruction while receiving treatment for childhood cancer. Consistent physical activity in adult survivors of childhood cancer has been associated with fewer cognitive problems …”

Section: Discussionmentioning

confidence: 99%

Clinical Care for People Who Survive Childhood Cancer

Bhatia,

Tonorezos,

Landier

2023

JAMA

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ImportanceAn estimated 15 000 children and adolescents aged 0 to 19 years are diagnosed with cancer each year in the US, and more than 85% survive for at least 5 years. By 45 years of age, approximately 95% of people who survive childhood cancer will develop a significant health problem related to the childhood cancer diagnosis or its treatment.ObservationsApproximately 500 000 people currently alive in the US have survived childhood cancer. The most common severe or life-threatening chronic health problems related to childhood cancer or its treatment are endocrine disorders such as hypothyroidism or growth hormone deficiency (44%), subsequent neoplasms such as breast cancer or thyroid cancer (7%), and cardiovascular disease such as cardiomyopathy or congestive heart failure, coronary artery disease, and cerebrovascular disease (5.3%). Medical conditions related to a cancer diagnosis during childhood or adolescence are most commonly caused by the radiation therapy and the chemotherapies used to treat cancer and may develop at varying lengths of time after exposure to these treatments. Individuals at highest risk for developing treatment-related health problems include patients with brain cancer treated with cranial irradiation (approximately 70% develop severe or life-threatening health problems) and allogeneic hematopoietic stem cell transplant recipients (approximately 60% develop severe or life-threatening health problems). Individuals at the lowest risk for developing treatment-related health problems include those who survived solid tumors (such as Wilms tumor) treated with surgical resection alone or with minimal chemotherapy, for whom the prevalence of subsequent health problems is similar to people who did not have cancer during childhood or adolescence. People diagnosed with childhood cancer in the 1990s who survived for at least 5 years after the cancer diagnosis have a shorter lifespan (by about 9 years) vs children who were not diagnosed with cancer in the 1990s.Conclusions and RelevanceApproximately 500 000 individuals currently alive in the US have survived childhood cancer. The most common adverse effects in individuals who survived childhood cancer are endocrine disorders, subsequent neoplasms, and cardiovascular disease. There is a need for clinicians and patients to have heightened awareness of these complications.

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Section: Discussionmentioning

confidence: 99%

Clinical Care for People Who Survive Childhood Cancer

Bhatia,

Tonorezos,

Landier

2023

JAMA

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“…Nonfebrile sei zures and cere bro vas cu lar stroke can occur dur ing front line ther apy for pedi at ric hema to logic malig nan cies and fur ther affect neurocognitive func tion. 15,16 The impact from these events is in addi tion to the risks asso ci ated with treat ment expo sures discussed above. It has been reported that severe infec tion and sep sis con fer addi tional risk for neurocog nitive impair ment on top of the known risk asso ci ated with CNS treat ment.…”

Section: Direct Neu Ro Tox Ic Itymentioning

confidence: 99%

Risk factors and screening for neurocognitive impacts of therapy

Krull

2022

Hematology

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Long-term survivors of pediatric hematologic malignancies are at elevated risk for neurocognitive impairment. Such impairment manifests in different ways at different times during survivorship, with deficits in processing speed, attention, and memory often appearing before deficits in executive function, intelligence, and academics. Survivors exposed to therapies that directly target the central nervous system (CNS), as is the case in acute lymphoblastic leukemia, may demonstrate subtle deficits during frontline therapy, and these deficits may grow and evolve over time. Survivors who do not receive CNS-directed therapies (eg, Hodgkin lymphoma) are also at elevated risk for neurocognitive impairment, although the influence on brain function is indirect through cancer therapy impact on systemic organ function vital to brain health (eg, cardiopulmonary morbidity). Over the course of the survivor's life span, the presence and impact of neurocognitive deficits will be determined by a complex interaction between premorbid development and environment, cancer therapy and clinical care, and posttreatment recovery and health. The timing and type of these treatment and health events will dictate the approach to screening and monitoring for neurocognitive impairment.

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“…Similarly, a high percentage of patients would report visual deficits, with a lower percentage of about 3% for cataracts to a higher proportion of patients complaining of diplopia (17%) [ 16 ]. Phillips et al suggest that pediatric CNS cancer survivors experience additional neurocognitive risk if they develop a seizure diagnosis, with seizure resolution associated with improved attention and memory [ 17 ]. In a large cohort of adults survivors of pediatric CNS tumors treated at St. Jude Children’s Research Hospital, the survivors with a history of seizures were at risk of severely impaired academics, attention, and memory dysfunction compared with those without a history of seizures, even after adjustment for cranial radiotherapy (CRT) exposure [ 18 ].…”

Section: Neurologic and Sensory Late Effectsmentioning

confidence: 99%

“…Vision impairment can also impact performance on some neuropsychological tests and needs to be considered as a risk factor before and after RT. Achieving seizure resolution is a crucial step toward improving neurocognitive outcomes in CNS cancer survivors [ 17 ].…”

Section: Strategy Of Monitoring and Potential Interventionmentioning

confidence: 99%

Neuropsychological Outcomes of Children Treated for Brain Tumors

Pancaldi

Pugliese²,

Migliozzi³

et al. 2023

Children

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Central nervous system (CNS) neoplasms are the most common solid tumors diagnosed in children. CNS tumors represent the leading cause of cancer death and cancer-related morbidity for children less than 20 years of age, although there has been a moderate increase in survival rates over the past several decades. The average survival at 5 years now nearly reaches 75%, and for some, non-malignant histology approximates 97% at 20 years from diagnosis. Neurological, cognitive, and neuropsychological deficits are the most disabling long-term effects of brain tumors in children. Childhood is a time of extreme brain sensitivity and the time of life in which most brain development occurs. Thus, the long-term toxicities that children treated for CNS tumors experience can affect multiple developmental domains and day-to-day functioning, ultimately leading to a poor quality of survival (QoS). We reviewed literature focusing on the risk factors for cognitive and neuropsychological impairment in pediatric patients treated for brain tumors with the aim of better understanding who is at major risk and what the best strategies for monitoring these patients are.

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Seizures' impact on cognition and quality of life in childhood cancer survivors

Cited by 12 publications

References 49 publications

Clinical Care for People Who Survive Childhood Cancer

Clinical Care for People Who Survive Childhood Cancer

Risk factors and screening for neurocognitive impacts of therapy

Neuropsychological Outcomes of Children Treated for Brain Tumors

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