Table 5.
Multivariable model of all patient, treatment, and medical factors associated with self-reported impaired neurocognitive functioning among non-central nervous system cancer survivors*
| Task efficiency |
Organization |
Memory |
Emotional regulation |
|||||
| Variables | PR (95% CI) | P† | PR (95% CI) | P | PR (95% CI) | P | PR (95% CI) | P |
| Age at evaluation | ||||||||
| 17–24 y | 1.1 (0.9 to 1.3) | .38 | 1.1 (0.8 to 1.5) | .52 | 1.3 (1.0 to 1.7) | .09 | 1.1 (0.9 to 1.3) | .36 |
| 25–34 y | 0.9 (0.8 to 1.1) | .26 | 1.0 (0.8 to 1.2) | .78 | 1.1 (0.9 to 1.3) | .61 | 0.9 (0.8 to 1.1) | .23 |
| ≥35 y | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | ||||
| Age at diagnosis | ||||||||
| 0–5 y | 1.3 (1.1 to 1.5) | <.001 | 1.1 (0.9 to 1.3) | .63 | 1.3 (1.0 to 1.6) | .02 | 1.3 (1.1 to 1.5) | <.001 |
| ≥6 y | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | ||||
| Sex | ||||||||
| Female | 1.3 (1.1 to 1.4) | <.001 | 1.0 (0.8 to 1.1) | .77 | 2.0 (1.7 to 2.3) | <.001 | ||
| Male | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | |||||
| CRT | ||||||||
| >18 Gy | 1.7 (1.4 to 1.9) | <.001 | 1.0 (0.8 to 1.3) | .91 | 1.2 (0.9 to 1.5) | .16 | ||
| >0 and ≤18 Gy | 1.6 (1.3 to 1.9) | <.001 | 0.9 (0.7 to 1.2) | .62 | 1.0 (0.8 to 1.3) | .75 | ||
| None | 1.0 (ref.) | 1.0 (ref.) | ||||||
| CRT stratified by sex | ||||||||
| Female | ||||||||
| >18 Gy | 2.1 (1.7 to 2.5) | <.001 | ||||||
| >0 and ≤18 Gy | 2.0 (1.6 to 2.4) | <.001 | ||||||
| No CRT | 1.1 (1.0 to 1.3) | .21 | ||||||
| Male | ||||||||
| ≤18 Gy | 1.4 (1.1 to 1.7) | .007 | ||||||
| >0 and ≤18 Gy | 1.3 (1.0 to 1.7) | .04 | ||||||
| No CRT | 1.0 (ref.) | |||||||
| Corticosteroid | ||||||||
| Dexamethasone ± prednisone | 1.0 (0.7 to 1.2) | .71 | 0.8 (0.6 to 1.2) | .36 | 1.1 (0.8 to 1.6) | .55 | 1.0 (0.7 to 1.2) | .77 |
| Prednisone only | 1.1 (0.9 to 1.3) | .22 | 1.2 (0.9 to 1.4) | .22 | 1.2 (1.0 to 1.5) | .08 | 1.1 (0.9 to 1.3) | .24 |
| None | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | ||||
| Methotrexate IT therapy | ||||||||
| Yes | 1.0 (0.8 to 1.1) | .64 | 0.9 (0.7 to 1.2) | .67 | 1.0 (0.8 to 1.3) | .83 | 1.0 (0.8 to 1.1) | .71 |
| No | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | ||||
| Methotrexate IV + IM dose | ||||||||
| None | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | ||||
| 0.1–5000 mg/m2 | 1.2 (1.0 to 1.4) | .04 | 1.1 (0.9 to 1.4) | .36 | 0.9 (0.7 to 1.2) | .63 | 1.2 (1.0 to 1.4) | .05 |
| >5000 mg/m2 | 1.1 (0.9 to 1.3) | .42 | 0.9 (0.7 to 1.2) | .33 | 1.0 (0.8 to 1.3) | .76 | 1.1 (0.9 to 1.3) | .40 |
| Anthracycline dose (tertiles) | ||||||||
| None | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | ||||
| Low (≤100 mg/m2) | 0.9 (0.7 to 1.0) | .07 | 0.7 (0.6 to 1.0) | .03 | 0.8 (0.7 to 1.1) | .16 | 0.9 (0.7 to 1.0) | .07 |
| Moderate (101–400 mg/m2) | 1.0 (0.9 to 1.2) | .88 | 1.2 (0.9 to 1.5) | .14 | 1.0 (0.8 to 1.3) | .93 | 1.0 (0.9 to 1.2) | .90 |
| High (>400 mg/m2) | 0.9 (0.7 to 1.0) | .13 | 1.0 (0.8 to 1.3) | .85 | 0.8 (0.6 to 1.0) | .09 | 0.9 (0.7 to 1.0) | .13 |
| Cyclophosphamide dose (tertiles) | ||||||||
| None (referent) | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | ||||
| Low (≤4480 mg/m2) | 1.1 (0.9 to 1.3) | .21 | 1.1 (0.9 to 1.4) | .53 | 0.9 (0.7 to 1.1) | .34 | 1.1 (0.9 to 1.3) | .21 |
| Moderate (4481–9750 mg/m2) | 1.1 (1.0 to 1.3) | .15 | 1.0 (0.8 to 1.3) | 1.00 | 1.1 (0.9 to 1.4) | .29 | 1.1 (1.0 to 1.3) | .17 |
| High (>9751 mg/m2) | 1.0 (0.8 to 1.1) | .69 | 0.9 (0.7 to 1.2) | .47 | 1.1 (0.8 to 1.3) | .68 | 1.0 (0.8 to 1.1) | .67 |
| Sensory deficits | ||||||||
| Hearing ± visual | 1.7 (1.3 to 2.0) | <.001 | 1.6 (1.1 to 2.3) | .009 | 1.1 (0.7 to 1.6) | .78 | 1.6 (1.3 to 2.0) | <.001 |
| Visual only | 1.1 (0.9 to 1.4) | .22 | 1.0 (0.7 to 1.5) | .91 | 1.1 (0.8 to 1.6) | .40 | 1.1 (0.9 to 1.4) | .23 |
| Neither | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | 1.0 (ref.) | ||||
*
Displayed are prevalence ratios (PRs) of scores categorized as impaired (ie, in the worst 10% range of siblings scores). CI = confidence interval; CRT = cranial radiation therapy; IM = intramuscular; IT = intrathecal; IV = intravenous; ref. = referent.
†
Two-sided statistical inference from log-binomial regression or COPY method was used.