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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Since the 1960's there has been a marked increase in the 5-year survival rates among children diagnosed with cancer (current rate = 77%). Despite the favorable prognosis for survival, patients are at high risk for both acute and late occurring sequelae associated with their disease and treatments. Children who receive therapies that impact the central nervous system are at even higher risk for cognitive, social and psychological deficits. Collectively, these problems limit their quality of survival well into adulthood. As such, investigators have recently focused on development of interventions targeted at improving neurocognitive deficits in survivors, particularly problems with attention and working memory. One novel approach that has shown preliminary and robust efficacy in children with attention problems is computerized cognitive training (CT). However, such an intervention has never been empirically tested with survivors of childhood cancer. Therefore, given the preliminary nature of this field of investigation, prior to launching a large-scale randomized clinical trial, it is first of crucial importance to determine whether this type of home-based, computerized cognitive training task is feasible and acceptable for use with survivors of pediatric cancer. Acquisition of these data will allow us to power a larger intervention study with this vulnerable patient population. To this end, the current study has two specific aims: 1) to assess the feasibility and acceptability of a home- based, computerized attention training program with survivors of central nervous system (CNS) impacting pediatric cancer (e.g. ALL, brain tumors), and 2) to estimate the effect size of this attention training program with survivors of childhood cancer to determine whether a larger- scale clinical trial is warranted. We propose to pilot an 8-week randomized, placebo-controlled, CT intervention with a small sample of survivors of childhood cancer (n = 24). Feasibility, acceptability, and preliminary efficacy data will be collected post-treatment and after a 3-month follow-up period. Primary outcomes will be parent- and survivor-reported technical feasibility, ease-of-use, and satisfaction, as well as computer-tracked compliance, and performance on standardized measures of attention and working memory. We hypothesize that the intervention will be associated with adequate feasibility, acceptability, and compliance. Further, we predict that increases in working memory and attention from baseline to post-intervention will be of moderate effect size, and will be maintained at 3-month follow-up.