Abstract
Background: Acute Lymphoblastic leukemia (ALL) and Posterior Fossa Tumors (PFT) are the most common types of cancer in Brazilian children. Parallel to the sophistication of treatment and increased survival rates, the concern about the neurotoxicity of anti-neoplastic treatment and its impact on neurodevelopment has been growing. The objective of this study was to compare the cognitive impact of treatment modality on intellective capacity of children survivors of PFT and ALL. Method: 22 Children and adolescents aged from 6 to 14 years old have participated in this study, being 06 children diagnosed with Astrocytoma, 06 diagnosed with medulloblastoma and 10 diagnosed with ALL. Children with astrocytoma underwent surgery for tumor resection; children with medulloblastoma were submitted to surgical resection, systemic chemotherapy and cranial and neuraxis radiation therapy (54Gy) and; children with ALL underwent systemic and intrathecal chemotherapy. Intellectual functioning was evaluated through WISC-III, and performance of subgroups was compared using One Way ANOVA followed by post hoc LSD. Results: Children with astrocytoma obtained average performance in all assessed domains, while children with medulloblastoma and ALL obtained downgraded scores. In all indices children with ALL obtained better results than children with medulloblastoma, except on verbal scores (VIQ and VCI) and Freedom from Distractibility Index (FDI). Statistical analysis revealed significant contrasts in performance of groups, mainly between children with medulloblastoma and other groups in non-verbal scores, as Processing Speed Index (PSI). Conclusion: Data suggest that the combination of surgery, systemic chemotherapy and radiotherapy may intensify the incidence of cognitive effects. Moreover, reinforce the hypothesis that cranial radiation therapy underlies severe cognitive losses, through damage to cortical and subcortical white matter, so that motor and mental processing speed is affected. The combination of intrathecal and systemic chemotherapy in turn promotes significant impacts on executive functioning, in particular on working memory.
Highlights
Brazilian official data estimate that annually approximately 11,840 cases of neoplasias are diagnosed in children and adolescents
22 Children and adolescents aged from 6 to 14 years old have participated in this study, being 06 children diagnosed with Astrocytoma, 06 diagnosed with medulloblastoma and 10 diagnosed with Acute Lymphoblastic leukemia (ALL)
Children with astrocytoma underwent surgery for tumor resection; children with medulloblastoma were submitted to surgical resection, systemic chemotherapy and cranial and neuraxis radiation therapy (54Gy) and; children with ALL underwent systemic and intrathecal chemotherapy
Summary
Brazilian official data estimate that annually approximately 11,840 cases of neoplasias are diagnosed in children and adolescents. The north-eastern region of Brazil, reference of this study, has the second highest number of new cases per year, about 2790. Among all annual cases of cancer, approximately 35% are leukaemia, from which 75% are acute lymphoblastic leukaemia, and 15% are Central Nervous System tumours (CNS), of which 60% will occur in posterior fossa region, where astrocytomas and medulloblastomas are more often diagnosed [1]. Socioeconomic discrepancies affect educational level and health of the population and have a negative impact on diagnosis and treatment of childhood cancer – often late- and, on the possibility of rehabilitation in case of survival [2,3].
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
