Risk for neurocognitive impairment in Korean childhood cancer survivors

Background Neurocognitive impairment is one of the serious treatment-related late complications of childhood cancer survivors (CCS). This study aimed to evaluate neurocognitive impairment of Korean CCS at their adolescent and young age for whom little was known. Method We recruited 720 Korean CCS diagnosed with primary cancer before the age of 19 years and 222 siblings of CCS. We measured neurocognitive function using the Korean version of Neurocognitive Questionnaire (K-NCQ) composed of four subdomains, with cut-off level of impairment set at the upper 10% of score distribution among sibling group. We evaluated the risk of neurocognitive impairment in CCS as compared with sibling by multiple logistic regression analysis. Results Average (standard deviation) ages of CCS at cancer diagnosis and at survey was 9.3 (5.3) and 17.6 (5.1) years, respectively. Compared with siblings, prevalence and adjusted odds ratio (95% confidence interval) of neurocognitive impairment were significantly higher in CCS with CNS solid tumor for task efficiency (31.5% vs. 16.2%, 2.58(1.47, 4.50)) and organization (24.1% vs. 13.5%, 2.70(1.44, 5.07)) subdomains. Consistent findings were observed in the subgroup analysis of 156 CCS with sibling participants and their siblings (n = 183). However, CCS with non-CNS solid tumor or hematologic malignancy showed no increased risk of impairment for four subdomains of K-NCQ. Conclusion Young-aged Korean CNS solid tumor survivors may have a higher risk of neurocognitive impairment for task efficiency and organization subdomains. However, neurocognitive function for memory and emotional regulation subdomains did not differ between CCS and siblings.