Development of working memory, processing speed, and psychosocial functions in patients with pediatric cancer

Many patients after pediatric cancer suffer from long-term cognitive difficulties. This study investigates the development of cognitive and psychosocial functions between diagnosis and one year after cancer treatment and reveals insight into the association between cognitive and psychosocial development and various risk factors. This retrospective clinical record review included fifty-seven patients, aged 4-16 years, that were examined at the beginning of the cancer treatment (T1) and one year after cancer treatment (T2) to evaluate the development of working memory (WM), processing speed (PS), psychosocial functions, and quality of life (QoL). About half of the patients showed stable/favorable cognitive development (PS 51.9%; WM 41.4%). The other half exhibited a non-favorable cognitive development, with a decrease of performance between T1 and T2. In 51.6-77.4%, psychosocial functions remained stable/increased between T1 and T2 and QoL scores remained stable in 42.9-61.9%. Changes in prosocial behavior correlated with the development of PS (r = 0.472, p = 0.010). Age at T1 predicted PS at T2 (p = 0.020) and sex predicted peer relations at T2 (p = 0.046). About half of the patients showed stable/favorable whereas the other half experiencing non-favorable cognitive development. The observed disparities in initial and subsequent cognitive performances highlight the importance of early individualized patient monitoring and interventions. IMPACT: We investigated the cognitive and psychosocial development of pediatric cancer patients between diagnosis and one year after termination of cancer treatment. About half of the patients showed stable or favorable cognitive development in processing speed and working memory. The other half exhibited a non-favorable cognitive development, with decreasing performance. Baseline working memory and processing speed was negatively correlated with the respective change score. Changes in prosocial behavior were positively correlated with the development of processing speed. Early individualized patient monitoring and intervention is of crucial importance after pediatric cancer and its treatment.