Intelligence and posterior fossa tumors in Brazilian youth

Abstract

Central nervous system tumors are the most frequent solid neoplasms in childhood and are frequently located in posterior fossa (PF). In Brazil, this diagnosis is associated to high mortality rates and this context is increasingly worrisome outside of large urban centers in which delayed diagnosis and defaulting from treatment compromise survivorship. Moreover, the lesion and therapeutic toxicity compromise cognitive domains. This study investigated the impact of PF tumors and their treatments on the intellectual capacity of 37 children and adolescents aged 6 to 16, divided into two groups: patients with low grade tumors, submitted only to neurosurgery (G1) and with tumors of higher malignancy submitted to neurosurgery, chemotherapy, and/or radiotherapy (G2). Using the Wechsler Intelligence Scales for Children, data reveal that G1 presented preserved mean performance, while G2 presented low average performance. Cluster-type analysis divided the participants into two groups regarding intelligence, clinical and sociodemographic variables. Inferential statistical analysis highlighted the influence of antineoplastic treatment on nonverbal domains. Mother's schooling demonstrated influence on verbal domains, revealing an important dissociation pattern. The results suggest the relevance of sociocultural factors on the expression of the damage, as well as the administration of radiotherapy at critical neurodevelopmental stages.