- Non-pharmacological interventions are recommended by NCI and are the principal focus for managing cancer-related cognitive impairment in childhood and adolescent survivors.
- Structured cognitive training, cognitive-motor and physical activity interventions, including exergaming and web-based formats, show improvements in intellectual function and cognitive abilities.
- Integrate NPIs into coordinated survivorship care across healthcare, educational and family systems; additional RCTs are needed for rigorous synthesis and age-specific targeting.
Neurosci Biobehav Rev. 2026 Nov 3:107067. doi: 10.1016/j.neubiorev.2026.107067. Online ahead of print.
ABSTRACT
Childhood cancer survivors (CCSs) experience a premature onset of ageing-related morbidities, including cancer-related cognitive impairment (CRCI), attributable to epigenetic age acceleration (EAA). The National Cancer Institute (NCI) recommended non-pharmacological strategies (NPIs) as the optimal approach. To address current gaps in the literature, we conducted a systematic review of RCTs across six databases to provide a comprehensive overview of NPIs for managing CRCI in CCSs and adolescents, following the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Thirteen publications and eleven RCTs were included, including two quasi-experimental and six pilot and feasibility studies. The sample included individuals aged 4 to 17 years with solid brain and haematological tumours. Strategies included academic skills interventions, cognitive-motor training with digital and analogue systems, computerised and non-computerised cognitive training, web-based physical activity, and physical activity with active video gaming or exergaming. The results suggest improvements in intellectual function and cognitive abilities following structured cognitive training programs. The integration of these interventions in a coordinated survivorship care plan across healthcare, educational, and family systems will support the cognitive development and adaptive outcomes to reduce learning and social disparities in children and adolescents with cancer. Further RCTs are needed to allow for rigorous quantitative data synthesis and to target specific age groups.
PMID:42976972 | DOI:10.1016/j.neubiorev.2026.107067
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