Consensus-based recommendation for surveillance of neurocognitive problems

This page is part of the PanCare follow-up recommendations for surveillance of late effects. Click here, for more information on these recommendations.

Who is at risk for neurocognitive problems?

CAYA cancer survivors treated with or with a history of

  • a CNS tumour
  • brain surgery
  • radiotherapy to a volume exposing the brain, including TBI
  • high dose cytarabine IV
  • high dose methotrexate IV
  • any chemotherapy IT
    especially if the survivor was treated at a young age

What neurocognitive problems might occur?

Problems in the following cognitive domains:

  • Academic and school performance
  • Attention
  • Executive functions
  • Intelligence
  • Language
  • Memory
  • Processing speed
  • Visual-motor integration

What surveillance modality should be used and at what frequency should it be performed?

  • A history with specific attention to educational and/or vocational progress or decline
    at least every 2 years in survivors ≤ 18 years of age, and at least every 5 years in survivors > 18 years of age

What should be done if abnormalities are identified?

  • Refer to a (neuro)psychologist for a formal neuropsychological evaluation

IV = intravenous, IT = intrathecal