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Investiga??o da capacidade intelectiva de pacientes pedi?tricos diagnosticados com tumores de fossa posteriorGarcia, Danielle Ferreira 01 April 2011 (has links)
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Previous issue date: 2011-04-01 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Central Nervous System are the most common pediatric solid tumors. 60% of these
tumors arise in posterior fossa, mainly in cerebellum. The first therapeutic approach is
surgical resection. Malignant tumors require additional strategies - chemotherapy and
radiotherapy. The increasing survival evidences that childhood brain tumors result in
academic and social difficulties that compromise the quality of life of the patients. This
study investigated the intellectual functioning of children between 7 to 15 years
diagnosed with posterior fossa tumors and treated at CEHOPE - Recife / PE. 21 children
were eligible - including 13 children with pilocytic astrocytoma (G1) who underwent
only surgery resection, and eight children with medulloblastoma (G2) - submitted to
surgical resection, chemotherapy and craniospinal radiotherapy. Participants were
evaluated by the Wechsler Intelligence Scale for Children - WISC-III. Children of G1
scored better than children of G2. Inferential tools (Mann-Whitney ? Test) identified
significant diferences (p ≤ 0.05) between the Performance IQ (PIQ) and Processing
Speed Index (PSI) as a function of treatment modality; Full Scale IQ (FSIQ), PIQ and
PSI as a function of parental educational level; PIQ, FSIQ, IVP and Freedom from
Distractibility (FDI) as a function of time between diagnosis and evaluation. These
results showed the late and progressive impact of radiotherapy on white matter and
information processing speed. Furthermore, children whose parents have higher
educational level showed better intellectual performance, indicating the influence of
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socio-cultural variables on cognitive development. The impact of cancer and its
treatment on cognitive development and learning should not be underestimated. These
results support the need to increase the understanding of such effects in order to propose
therapeutic strategies which ensure that, in addition to the cure, the full development of
children with this pathology / Os tumores de Sistema Nervoso Central s?o as neoplasias s?lidas mais frequentes na
inf?ncia. 60% desses tumores ocorrem na fossa posterior, cujo principal componente ? o
cerebelo. A primeira interven??o ? a ressec??o cir?rgica; tumores malignos requerem
estrat?gias terap?uticas complementares quimioterapia e radioterapia. O aumento da
sobrevida evidenciou que crian?as com tumores cerebrais apresentam dificuldades
acad?mico-sociais que comprometem sua qualidade de vida. O objetivo deste estudo foi
investigar a capacidade intelectiva de crian?as de 6 a 16 anos com tumores de fossa
posterior. Participaram 21 crian?as atendidas pelo CEHOPE Recife/PE sendo 13
crian?as com astrocitoma piloc?tico (G1) - submetidas ? cirurgia de ressec??o e; oito
crian?as com meduloblastoma (G2) submetidas a cirurgia de ressec??o, quimioterapia
e radioterapia de cr?nio e neuro-eixo. Os participantes foram avaliados pelas Escalas
Wechsler de Intelig?ncia para Crian?as WISC-III. Crian?as de G1 obtiveram
desempenho superior ao de crian?as de G2. An?lises estat?sticas inferenciais (Teste ?
de Mann-Whitney) identificaram contrastes estatisticamente significativos (p≤0,05),
entre o QI de Execu??o (QIE) e ?ndice Fatorial Velocidade de Processamento (IVP) em
fun??o da modalidade de tratamento; QI Total, QIE e IVP em fun??o do n?vel de
escolaridade dos pais; QIE, QIT, IVP e ?ndice Fatorial Resist?ncia ? Distra??o (IRD)
em fun??o do tempo entre o diagn?stico e a avalia??o. Sugere-se o impacto tardio e
progressivo da radioterapia sobre a subst?ncia branca e sobre a velocidade de
processamento; crian?as cujos pais possuem maior n?vel de instru??o formal apresentam
melhor capacidade intelectiva, sugerindo a influ?ncia de vari?veis s?cio-culturais sobre
o desenvolvimento cognitivo. O impacto do c?ncer e seu tratamento sobre o
desenvolvimento e a aprendizagem n?o deve ser subestimado. Tais resultados refor?am
a necessidade de aprofundar a compreens?o sobre tais efeitos, visando propor
estrat?gias terap?uticas que garantam, al?m da reabilita??o cl?nica, o pleno
desenvolvimento das crian?as com esta patologia.
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