A study of the acute effects of chemotherapy on neurocognitive function among pediatric cancer patients
Despite improvements in cancer therapies that have resulted in increased survival rates among children with cancer, various chemotherapeutic agents have been associated with acute neurotoxicity and impairments in neurocognition. Methotrexate (MTX) has become a crucial component in the treatment of a number of childhood cancers but is often associated with these problems in pediatric populations. Although the neurocognitive late effects of chemotherapy are well documented in the pediatric literature, studies examining the effects of chemotherapy in children actively undergoing treatment are limited and findings have been inconsistent. This study sought to enhance the previous literature by examining the effects of MTX chemotherapy on neurocognition within three days following treatment administration. The study sample was comprised of 19 patients (11 males, 8 females) primarily of Hispanic origin (52.6%) with mixed cancer diagnoses. Mean age at the time of testing was 12.8 years. Participants completed a comprehensive battery of tests prior to receiving treatment and within 72 hours following treatment. The Rey Auditory Verbal Learning Test was used to assess verbal learning and memory. Visual memory was evaluated with the Rey-Osterrieth Complex Figure Test (ROCFT) and Taylor Complex Figure (TCF). These measures also served as a measure of visuo-spatial/motor functioning. The Digit Span and Letter Number Sequencing subtests from either the WISC-IV or WAIS-III were administered at both the pre- and post- treatment trials as measures of working memory. The Conners’ Continuous Performance Test- Second Edition was used to assess attention and concentration. Primary findings indicated that pediatric patients experience significant declines in verbal learning and memory functions following treatment with MTX chemotherapy. Results revealed that younger children may be at increased risk for verbal memory impairment and other cognitive issues while treated with MTX. Overall, pediatric patients may experience significant verbal learning and memory deficits soon after receiving chemotherapy with MTX even in the absence of observable symptoms of acute neurotoxicity. These findings augment the previous literature by showing that deficits may manifest shortly after MTX administration. Implications of study findings for educators and clinicians are discussed and recommendations for future research are presented.
Dorfman, Ava, "A study of the acute effects of chemotherapy on neurocognitive function among pediatric cancer patients" (2011). ETD Collection for Fordham University. AAI3495887.