Cognitive function and social attainment in adult survivors of retinoblastoma

A report from the St. Jude Lifetime Cohort Study

Tara M. Brinkman, Thomas E. Merchant, Zhenghong Li, Rachel Brennan, Matthew Wilson, Mary Ellen Hoehn, Ibrahim Qaddoumi, Sean Phipps, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, Kevin R. Krull

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

BACKGROUND: Retinoblastoma has a 5-year survival rate exceeding 95%, yet little is known about long-term functional outcomes for these patients. METHODS: Sixty-nine adult survivors of retinoblastoma (mean age, 33 years; mean years post-diagnosis, 31) who had enrolled in the St. Jude Lifetime Cohort Study completed clinical cognitive evaluations and questionnaires assessing adult social attainment. Scores on all cognitive measures were converted to z-scores (M = 0, SD = 1) using age-adjusted normative data. Multivariable linear regression analyses, adjusted for age at diagnosis and disease laterality, were used to examine associations between disease and treatment exposures and cognitive outcomes. RESULTS: Retinoblastoma survivors performed within normative expectations across most cognitive domains. In multivariable models, adjusted for disease laterality, survivors diagnosed at <1 year of age performed significantly better on measures of short-term verbal memory (β=0.87, P<.01), long-term verbal memory (β=0.66, P=.02), verbal learning (β = 0.67, P=.02), and verbal reasoning abilities (β = 0.79, P<.01) compared with survivors diagnosed at ≤1 year of age. In multivariable models, restricted to bilateral survivors and adjusted for age at diagnosis, whole brain radiation exposure was significantly associated with poorer performance on tasks of short-term verbal memory (β=-0.003, P = .03) and long-term verbal memory (β = 20.003, P = .01). Reported social attainment was consistent with adult developmental expectations. CONCLUSIONS: Adult survivors of retinoblastoma demonstrate few cognitive or social attainment deficits decades following diagnosis and treatment. Findings suggest the potential for neural reorganization following early insult to the visual system as well as vulnerability of the developing brain to low dose radiation exposure. Early intervention and rehabilitation will be important for these patients.

Original languageEnglish (US)
Pages (from-to)123-131
Number of pages9
JournalCancer
Volume121
Issue number1
DOIs
StatePublished - Jan 1 2015

Fingerprint

Retinoblastoma
Cognition
Survivors
Cohort Studies
Long-Term Memory
Short-Term Memory
Verbal Learning
Aptitude
Brain
Task Performance and Analysis
Linear Models
Rehabilitation
Survival Rate
Regression Analysis
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Cognitive function and social attainment in adult survivors of retinoblastoma : A report from the St. Jude Lifetime Cohort Study. / Brinkman, Tara M.; Merchant, Thomas E.; Li, Zhenghong; Brennan, Rachel; Wilson, Matthew; Hoehn, Mary Ellen; Qaddoumi, Ibrahim; Phipps, Sean; Srivastava, Deokumar; Robison, Leslie L.; Hudson, Melissa M.; Krull, Kevin R.

In: Cancer, Vol. 121, No. 1, 01.01.2015, p. 123-131.

Research output: Contribution to journalArticle

Brinkman, TM, Merchant, TE, Li, Z, Brennan, R, Wilson, M, Hoehn, ME, Qaddoumi, I, Phipps, S, Srivastava, D, Robison, LL, Hudson, MM & Krull, KR 2015, 'Cognitive function and social attainment in adult survivors of retinoblastoma: A report from the St. Jude Lifetime Cohort Study', Cancer, vol. 121, no. 1, pp. 123-131. https://doi.org/10.1002/cncr.28924
Brinkman, Tara M. ; Merchant, Thomas E. ; Li, Zhenghong ; Brennan, Rachel ; Wilson, Matthew ; Hoehn, Mary Ellen ; Qaddoumi, Ibrahim ; Phipps, Sean ; Srivastava, Deokumar ; Robison, Leslie L. ; Hudson, Melissa M. ; Krull, Kevin R. / Cognitive function and social attainment in adult survivors of retinoblastoma : A report from the St. Jude Lifetime Cohort Study. In: Cancer. 2015 ; Vol. 121, No. 1. pp. 123-131.
@article{15a5782591ef4a33b0eac7dd5ed36961,
title = "Cognitive function and social attainment in adult survivors of retinoblastoma: A report from the St. Jude Lifetime Cohort Study",
abstract = "BACKGROUND: Retinoblastoma has a 5-year survival rate exceeding 95{\%}, yet little is known about long-term functional outcomes for these patients. METHODS: Sixty-nine adult survivors of retinoblastoma (mean age, 33 years; mean years post-diagnosis, 31) who had enrolled in the St. Jude Lifetime Cohort Study completed clinical cognitive evaluations and questionnaires assessing adult social attainment. Scores on all cognitive measures were converted to z-scores (M = 0, SD = 1) using age-adjusted normative data. Multivariable linear regression analyses, adjusted for age at diagnosis and disease laterality, were used to examine associations between disease and treatment exposures and cognitive outcomes. RESULTS: Retinoblastoma survivors performed within normative expectations across most cognitive domains. In multivariable models, adjusted for disease laterality, survivors diagnosed at <1 year of age performed significantly better on measures of short-term verbal memory (β=0.87, P<.01), long-term verbal memory (β=0.66, P=.02), verbal learning (β = 0.67, P=.02), and verbal reasoning abilities (β = 0.79, P<.01) compared with survivors diagnosed at ≤1 year of age. In multivariable models, restricted to bilateral survivors and adjusted for age at diagnosis, whole brain radiation exposure was significantly associated with poorer performance on tasks of short-term verbal memory (β=-0.003, P = .03) and long-term verbal memory (β = 20.003, P = .01). Reported social attainment was consistent with adult developmental expectations. CONCLUSIONS: Adult survivors of retinoblastoma demonstrate few cognitive or social attainment deficits decades following diagnosis and treatment. Findings suggest the potential for neural reorganization following early insult to the visual system as well as vulnerability of the developing brain to low dose radiation exposure. Early intervention and rehabilitation will be important for these patients.",
author = "Brinkman, {Tara M.} and Merchant, {Thomas E.} and Zhenghong Li and Rachel Brennan and Matthew Wilson and Hoehn, {Mary Ellen} and Ibrahim Qaddoumi and Sean Phipps and Deokumar Srivastava and Robison, {Leslie L.} and Hudson, {Melissa M.} and Krull, {Kevin R.}",
year = "2015",
month = "1",
day = "1",
doi = "10.1002/cncr.28924",
language = "English (US)",
volume = "121",
pages = "123--131",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "1",

}

TY - JOUR

T1 - Cognitive function and social attainment in adult survivors of retinoblastoma

T2 - A report from the St. Jude Lifetime Cohort Study

AU - Brinkman, Tara M.

AU - Merchant, Thomas E.

AU - Li, Zhenghong

AU - Brennan, Rachel

AU - Wilson, Matthew

AU - Hoehn, Mary Ellen

AU - Qaddoumi, Ibrahim

AU - Phipps, Sean

AU - Srivastava, Deokumar

AU - Robison, Leslie L.

AU - Hudson, Melissa M.

AU - Krull, Kevin R.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - BACKGROUND: Retinoblastoma has a 5-year survival rate exceeding 95%, yet little is known about long-term functional outcomes for these patients. METHODS: Sixty-nine adult survivors of retinoblastoma (mean age, 33 years; mean years post-diagnosis, 31) who had enrolled in the St. Jude Lifetime Cohort Study completed clinical cognitive evaluations and questionnaires assessing adult social attainment. Scores on all cognitive measures were converted to z-scores (M = 0, SD = 1) using age-adjusted normative data. Multivariable linear regression analyses, adjusted for age at diagnosis and disease laterality, were used to examine associations between disease and treatment exposures and cognitive outcomes. RESULTS: Retinoblastoma survivors performed within normative expectations across most cognitive domains. In multivariable models, adjusted for disease laterality, survivors diagnosed at <1 year of age performed significantly better on measures of short-term verbal memory (β=0.87, P<.01), long-term verbal memory (β=0.66, P=.02), verbal learning (β = 0.67, P=.02), and verbal reasoning abilities (β = 0.79, P<.01) compared with survivors diagnosed at ≤1 year of age. In multivariable models, restricted to bilateral survivors and adjusted for age at diagnosis, whole brain radiation exposure was significantly associated with poorer performance on tasks of short-term verbal memory (β=-0.003, P = .03) and long-term verbal memory (β = 20.003, P = .01). Reported social attainment was consistent with adult developmental expectations. CONCLUSIONS: Adult survivors of retinoblastoma demonstrate few cognitive or social attainment deficits decades following diagnosis and treatment. Findings suggest the potential for neural reorganization following early insult to the visual system as well as vulnerability of the developing brain to low dose radiation exposure. Early intervention and rehabilitation will be important for these patients.

AB - BACKGROUND: Retinoblastoma has a 5-year survival rate exceeding 95%, yet little is known about long-term functional outcomes for these patients. METHODS: Sixty-nine adult survivors of retinoblastoma (mean age, 33 years; mean years post-diagnosis, 31) who had enrolled in the St. Jude Lifetime Cohort Study completed clinical cognitive evaluations and questionnaires assessing adult social attainment. Scores on all cognitive measures were converted to z-scores (M = 0, SD = 1) using age-adjusted normative data. Multivariable linear regression analyses, adjusted for age at diagnosis and disease laterality, were used to examine associations between disease and treatment exposures and cognitive outcomes. RESULTS: Retinoblastoma survivors performed within normative expectations across most cognitive domains. In multivariable models, adjusted for disease laterality, survivors diagnosed at <1 year of age performed significantly better on measures of short-term verbal memory (β=0.87, P<.01), long-term verbal memory (β=0.66, P=.02), verbal learning (β = 0.67, P=.02), and verbal reasoning abilities (β = 0.79, P<.01) compared with survivors diagnosed at ≤1 year of age. In multivariable models, restricted to bilateral survivors and adjusted for age at diagnosis, whole brain radiation exposure was significantly associated with poorer performance on tasks of short-term verbal memory (β=-0.003, P = .03) and long-term verbal memory (β = 20.003, P = .01). Reported social attainment was consistent with adult developmental expectations. CONCLUSIONS: Adult survivors of retinoblastoma demonstrate few cognitive or social attainment deficits decades following diagnosis and treatment. Findings suggest the potential for neural reorganization following early insult to the visual system as well as vulnerability of the developing brain to low dose radiation exposure. Early intervention and rehabilitation will be important for these patients.

UR - http://www.scopus.com/inward/record.url?scp=84918834488&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84918834488&partnerID=8YFLogxK

U2 - 10.1002/cncr.28924

DO - 10.1002/cncr.28924

M3 - Article

VL - 121

SP - 123

EP - 131

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 1

ER -