Evaluation of Cognitive Function in Chilhood Cancer Patients

Abstract

BACKGROUND: Survival rates of children with cancer are currently increasing. The long-term effects of chemotherapy as primary treatment for childhood cancer patients urge physicians’ considerations. Cognitive dysfunction, as one of devastating long-term effects of chemotherapy, is known to disrupt quality of life in childhood cancer patients.

METHODS: The objective of this study was to investigate cognitive function in childhood cancer patients. This cross-sectional study was conducted from April to November 2019 at Haji Adam Malik General Hospital, Medan, North Sumatera. Fifty-four childhood cancer patients who received chemotherapy were enrolled. Cognitive function in childhood cancer patients were measured with Wechsler Intelligence Scale for Children-Revised (WISC-R) test, composed of Full scale IQ (F IQ), Verbal scale IQ (V IQ), and Performance scale IQ (P IQ) scores.

RESULTS: The WISC-R test results showed median F IQ, V IQ, and P IQ scores of 86 (47-114), 85 (44-115), and 85 (22-113), respectively. There was no significant difference of IQ scores between male and female patients. Children with age of diagnosis <6 years old had higher F IQ and V IQ [89 (80-105) vs. 84.5 (47-114) and 93.5 (79-109) vs. 81 (44-115); P=0.04 and P=0.02, respectively). There was no correlation between chemotherapy duration and intrathecal (IT) methotrexate administration with cognitive function. However, administration of high dose intravenous (IV) methotrexate had a negative correlation with F IQ, V IQ, and P IQ (r=-0.436, r=-0.381, and r=-0.392; P=0.007, P=0.017, and P=0.015, respectively).

CONCLUSION: High dose IV methotrexate compromises cognitive function in childhood cancer patients, therefore evaluation of cognitive function is warranted.