Treatment Related Cognitive Impairment in Pediatric Oncology Patients: A Brazilian ExperienceIzabel Hazin1*, Danielle Garcia1, Ediana Gomes1, Bruna Balaban Garcia1, Débora Sunaly1, Amanda Guerra1, Carolina Vilar1, Francisco Pedrosa2 and Arli Pedrosa2
- *Corresponding Author:
- Izabel Hazin
Universidade Federal do Rio Grande do Norte, Brazil
Tel: 55 8488491970
E-mail: [email protected]
Received date : April 03, 2014; Accepted date : May 20, 2014; Published date : May 27, 2014
Citation: Hazin I, Garcia D, Gomes E, Garcia BB, Sunaly D, et al. (2014) Treatment Related Cognitive Impairment in Pediatric Oncology Patients: A Brazilian Experience. J Nucl Med Radiat Ther 5:174. doi:10.4172/2155-9619.1000174
Copyright: © 2014 Hazin l, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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.