The findings offer good news for patients, but it's
important to continue to monitor for long-term effects as the brain changes
While most children with retinoblastoma are successfully
cured, little is known about the long-term health of survivors. Given the very
young age at which retinoblastoma patients are treated (usually before 5 years
of age), and the intensive and multifaceted therapies they receive, survivors
are likely at risk for disease- and treatment-related late effects.
To assess links between the disease or its treatment with
cognitive and social problems later in life, Tara Brinkman, PhD, of St. Jude
Children's Research Hospital in Memphis, and her colleagues studied 69 adult
survivors who were an average of 33 years of age and had been treated for
retinoblastoma an average of 31 years earlier.
After participants completed cognitive evaluations and
questionnaires, the investigators found that survivors performed normally on
most cognitive and social measures. Whole brain radiation treatment was linked
with poorer performance on tasks of short-term verbal memory and long-term
Survivors diagnosed before 1 year of age performed
significantly better on measures of short-term verbal memory, long-term verbal
memory, verbal learning, and verbal reasoning abilities compared with survivors
diagnosed after 1 year of age. "This may be because the area of the brain
responsible for processing visual information becomes more adept at processing verbal
information following reduced visual input early in life. This suggests the
potential of the brain to adapt and reorganize following very early insult,"
said Dr. Brinkman.
"To our knowledge, this is the first study to report
on long-term cognitive and social outcomes in adult survivors of
retinoblastoma. Importantly, we found that, as a whole, these survivors are
doing quite well," Dr. Brinkman said. Additional research is needed to better
understand the mechanisms underlying potential brain changes and changes in
cognitive functioning in retinoblastoma survivors," she added.