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Neurological QuickFact

Childhood cancer survivors can be at risk for developing the following neurological late effects:

  • Peripheral Sensory/Motor Neuropathy
  • Cerebrovascular Complications
    • Stroke
    • Moyamoya
    • Occlusive Cerebral Vasculopathy
    • Cavernomas
  • Clinical Leukoencephalopathy
  • Motor and/or Sensory Deficits
  • Seizures
  • Hydrocephalus or Shunt Malfunction
  • Neurogenic Bladder or Bowel
    • Incontinence  
  • Sexual Dysfunction (Male and Female)

See Cognitive/School Quick Fact for the neurocognitive late effects.

If your patient does not have a Survivor Health Plan (SHP), please refer him/her to the appropriate survivor clinic. 

 

Important factors in determining risk for neurological late effects:

 

    • Time since treatment
    • Age at treatment
    • Tumor of the brain or spine
    • CNS directed therapy
    • Total dose of radiation
    • Total dose of chemotherapy

For recommendations on how to screen for all potential late effects, please refer to The Children’s Oncology Group Long-Term Follow-Up Guidelines.

 

 

Chemotherapy

Table 1

 

Peripheral Sensory/ Motor Neuropathy

Cerebrovascular Complications

Clinical Leuko-encephalopathy

Motor and/or Sensory Deficits

Seizures

Hydrocephalus

Shunt Malfunction

Neurogenic   Bladder or Bowel

Sexual Dysfunction

 

Alkylating                 Agents

Carmustine

   BCNU

Busulfan

Lomustine

   CCNU

Chlorambucil Cyclophosphamide

   Cytoxan

Ifosphamide

Mechlorethamine

Melphalan

Procarbazine

Thiotepa

 

Dacarbazine

    DTIC

Temozolomide

 

 

 

 

 

 

 

 

Heavy Metals

Carboplatin

Cisplatin

 

X

(Sensory only)

 

 

 

 

 

 

 

Antimetabolites

Cytarabine

   Ara-C

Mercaptopurine

   6MP

Thioguanine

   6TG

Methotrexate

 

 

 

X
(High dose Methotrexate and Cytarabine; Intrathecal  Methotrexate)

 

 

 

 

 

Anthracycline antibiotics

Daunorubicin

Doxorubicin

   Adriamycin

Epirubicin

Idarubicin

Mitoxantrone

 

 

 

 

 

 

 

 

 

Chemotherapy

Table 2

Peripheral Sensory/ Motor Neuropathy

Cerebrovascular Complications

Clinical Leuko-encephalopathy

Motor and/or Sensory Deficits

Seizures

Hydrocephalus

Shunt Malfunction

Neurogenic   Bladder or Bowel

Sexual Dysfunction

 

Anti-tumor antibiotics

Bleomycin

Dactinomycin

 

 

 

 

 

 

 

 

Corticosteroids

Dexamethasone

   Decadron

Prednisone

 

 

 

 

 

 

 

 

 

Enzymes

Asparaginase

 

 

 

 

 

 

 

 

 

Plant alkaloids

Vincristine

Vinblastine

 

X

 

 

 

 

 

 

 

Epipodophyllotoxins

Etoposide

   VP16

Teniposide

   VM26

 

 

 

 

 

 

 

 

 

 

Radiation

Peripheral Sensory/ Motor Neuropathy

Cerebrovascular Complications

Clinical Leuko-encephalopathy

Motor and/or Sensory Deficits

Seizures

Hydrocephalus

Shunt Malfunction

Neurogenic   Bladder or Bowel

Sexual Dysfunction

 

All Radiation                 

 

 

 

 

 

 

 

 

TBI

 

 

X

 

 

 

 

 

Head/Brain

 

> 18 Gy

 

Include TBI in total dose calculation

X

 

 

 

 

 

Neck

 

 

 

 

 

 

 

 

Thorax

 

 

 

 

 

 

 

 

Abdomen

 

 

 

 

 

 

 

 

Pelvis

 

 

 

 

 

 

 

 

Extremity

 

 

 

 

 

 

 

 

 

Surgery

Peripheral Sensory/

Motor Neuropathy

Cerebrovascular Complications

Clinical Leuko-encephalopathy

Motor and/or Sensory Deficits

Seizures

Hydrocephalus

Shunt Malfunction

Neurogenic   Bladder or Bowel

Sexual Dysfunction

 

Neurosurgery - Brain                          

 

 

 

X

X

X

 

 

Neurosurgery - Spine

 

 

 

 

 

 

X

X

Pelvic surgery

 

 

 

 

 

 

X

X

Cystectomy

 

 

 

 

 

 

X

X

 

Health Links-Teaching Handouts from The Children's Oncology Group       

Visit www.survivorshipguidelines.org  to find many of the Health Links translated into other languages.  

References:

Children’s Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers, and related Health Links  Version 4.0. October, 2013. www.survivorshipguidelines.org.

Source: Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta
Last Updated: 2/5/2015 5:41:06 PM
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