Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-12-12T17:04:09Z No. of bitstreams: 1 EdianaRossellyDeOliveiraGomes_TESE.pdf: 1689322 bytes, checksum: 0bc5f7755d331027c979d66f660e2ed6 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-12-12T20:27:40Z (GMT) No. of bitstreams: 1 EdianaRossellyDeOliveiraGomes_TESE.pdf: 1689322 bytes, checksum: 0bc5f7755d331027c979d66f660e2ed6 (MD5) / Made available in DSpace on 2017-12-12T20:27:40Z (GMT). No. of bitstreams: 1 EdianaRossellyDeOliveiraGomes_TESE.pdf: 1689322 bytes, checksum: 0bc5f7755d331027c979d66f660e2ed6 (MD5) Previous issue date: 2017-09-29 / A leucemia linfoide aguda (LLA) ? o tipo de c?ncer mais comum entre crian?as e adolescentes. A sofistica??o dos processos diagn?sticos e terap?uticos promoveu a eleva??o da sobrevida e a redu??o das reca?das da doen?a. A inclus?o do tratamento profil?tico direcionado ao SNC, realizado atrav?s de quimioterapia e/ou radioterapia, tem sido apontada como essencial para o sucesso terap?utico, todavia parece relacionar-se ? emerg?ncia de efeitos neuropsicol?gicos tardios em cerca de 30% dos sobreviventes. Estudos sugerem que altera??es sobre dom?nios cognitivos espec?ficos contribuem para o decl?nio do funcionamento intelectual e dificuldades acad?micas. O objetivo geral da presente pesquisa foi investigar aspectos neuropsicol?gicos e acad?micos de crian?as e adolescentes sobreviventes de LLA. A pesquisa foi dividida em quatro estudos: 1) Funcionamento intelectual de crian?as e adolescentes diagnosticados com LLA; 2) Aten??o e fun??es executivas em pacientes pedi?tricos sobreviventes de LLA; 3) Tradu??o e adapta??o do Question?rio Comportamental Deasy-Spinetta (DSBQ); 4) Investiga??o de aspectos acad?micos em crian?as e adolescentes diagnosticados com LLA. Participaram desse estudo 26 crian?as e adolescentes sobreviventes de LLA submetidas exclusivamente ? quimioterapia (grupo cl?nico) e 26 crian?as e adolescentes saud?veis (grupo controle), al?m de 26 pais e 46 professores. O protocolo de avalia??o neuropsicol?gica contemplou os seguintes dom?nios: funcionamento intelectual, aten??o, mem?ria, fun??es executivas, habilidades acad?micas e aspectos comportamentais. Os resultados foram analisados por ferramentas estat?sticas descritivas e inferenciais. No estudo 1 o grupo cl?nico apresentou desempenho significativamente inferior ao grupo controle. A baixa escolaridade materna foi associada a menor desempenho nos dom?nios verbal, n?o-verbal e funcionamento intelectual global. A menor idade ao diagn?stico foi correlacionada com baixos desempenhos no dom?nio verbal, capacidade intelectual global e mem?ria operacional, estando esta ?ltima tamb?m associada ao maior tempo de conclus?o do tratamento. O estudo 2 evidenciou desempenho significativamente inferior do grupo cl?nico em aten??o e fun??es executivas, especialmente no subgrupo de crian?as diagnosticadas antes dos cinco anos de idade. Os resultados do estudo 3 sugeriram que o DSBQ apresenta validade aparente ou de face, sendo um instrumento de f?cil utiliza??o. No estudo 4 o grupo cl?nico apresentou resultados inferiores em aritm?tica, compreens?o de textos e nos processos de armazenamento, evolu??o da aprendizagem e recupera??o de informa??es. Dificuldades espec?ficas do funcionamento escolar associaram-se predominantemente com a menor idade da crian?a ao diagn?stico. Espera-se que o conhecimento produzido por esse estudo possa contribuir com o desenvolvimento de programas voltados para a reinser??o escolar e a elabora??o de pol?ticas p?blicas para essa popula??o cl?nica, bem como a realiza??o de estudos futuros em neuropsicologia do desenvolvimento e da aprendizagem. / Acute lymphoblastic leukemia (ALL) is the most common type of cancer among children and adolescents. The sophistication of the diagnostic and therapeutic processes has promoted an increase in survival and reduction of relapse of the disease. The inclusion of prophylactic CNS therapy, performed through chemotherapy and/or radiotherapy, has been identified as essential for therapeutic success, but it seems to be related to the emergence of late neuropsychological effects in about 30% of survivors. Studies suggest that changes in specific cognitive domains contribute to the decline of intellectual functioning and academic difficulties presented by this clinical population. The main objective of the present study was to investigate the neuropsychological and academic aspects of children and adolescents who survived ALL. The research was divided into four studies: 1) The intellectual functioning of children and adolescents diagnosed with ALL; 2) Attention and executive functions in pediatric survivors of ALL; 3) Translation and adaptation of the Deasy-Spinetta Behavioral Questionnaire (DSBQ); 4) Investigation of academic aspects in children and adolescents diagnosed with ALL. 26 children and adolescents surviving ALL who underwent chemotherapy (clinical group), 26 healthy children and adolescents (control group), 26 parents and 46 teachers took part in this study. The neuropsychological evaluation protocol included the following domains: intellectual functioning, attention, memory, executive functions, academic abilities and behavioral aspects. The results were analyzed by descriptive and inferential statistical tools. In study 1, the clinical group performed significantly lower than the control group. Maternal low schooling was associated with lower performance in verbal, nonverbal and global intellectual functioning. The younger age at diagnosis was correlated with low verbal domain, global intellectual capacity and working memory, and the latter was also associated with longer treatment completion time. Study 2 evidenced significantly lower performance of the clinical group in attention and executive functions, especially in the subgroup of children diagnosed before the age of five. The results of study 3 suggested that the DSBQ has an apparent or face validity, being a readily usable instrument. In study 4 the clinical group presented lower results in arithmetic, text comprehension and storage processes, learning evolution and information retrieval. Specific difficulties of school functioning were associated predominantly with the child's lower age at diagnosis. It is hoped that the knowledge produced by this study may contribute to the development of programs aimed at the reinsertion of the school and the elaboration of public policies for this clinical population, as well as the accomplishment of future studies in neuropsychology of development and learning.

Made available in DSpace on 2014-12-17T15:39:05Z (GMT). No. of bitstreams: 1 DeboraSLS_DISSERT.pdf: 842349 bytes, checksum: edfd0464865223ade8a750fe80589852 (MD5) Previous issue date: 2014-07-11 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The present study investigated the impact of the treatment modalities of Acute Lymphoblastic Leukemia on neurocognitive abilities of children and adolescents survivors, aged between 6 and 16 years of age, accompanied in pediatric oncology sectors of public health services in the cities of Campina Grande-PB and Natal-RN. The study included 52 children, 13 of these being children and adolescents diagnosed with leukemia and 39 healthy children matched in relation to the study group considering gender, age, school type and level of maternal education. Later the group of children with leukemia was subdivided into two subgroups depending on treatment modality which were submitted: Group 1A (only chemotherapy) and 1B (chemotherapy and radiotherapy). All participants were subjected to a battery of neuropsychological tests that investigated the following neurocognitive abilities: intellectual ability, memory system, attention, visuospatiality and visuoconstruction, processing speed and executive functions. Data were analyzed using descriptive and inferential measurements with the aid of the U test of Mann-Whitney and T test, considering the influence of the variables: sex, age at diagnosis, time since completion of treatment and level of schooling mothers, on the performance of children. Overall, it is concluded that the illness and the treatment of acute lymphoblastic leukemia significantly favors the emergence of cognitive deficits, particularly in terms of visuospatial skills, and executive skills visoconstrutivas. In turn, the treatment modality of radiotherapy is associated with the presence of more severe deficits, highlighting the significant impact on the speed of information processing. It is hoped that the results presented here will contribute to a better understanding of the nature and extent of neurocognitive effects arising ALL treatment / O presente estudo investigou o impacto das modalidades de tratamento da Leucemia Linf?ide Aguda sobre as habilidades neurocognitivas de crian?as e adolescentes sobreviventes, com faixa et?ria entre 6 e 16 anos de idade, acompanhados nos setores de oncologia pedi?trica de servi?os p?blicos de sa?de das cidades de Campina Grande- PB e Natal-RN. Participaram deste estudo 52 crian?as, sendo destas 13 crian?as e adolescentes diagnosticados com leucemia e 39 crian?as saud?veis pareadas em rela??o ao grupo de estudo considerando-se o sexo, idade, tipo de escola e n?vel de escolaridade materna. Posteriormente o grupo de crian?as com leucemia foi subdividido em dois subgrupos em fun??o da modalidade de tratamento as quais foram submetidos: Grupo 1A (exclusivamente tratamento quimioter?pico) e 1B (tratamento quimioter?pico e radioter?pico). Todos os participantes foram submetidos ? bateria de testes neuropsicol?gicos que investigou as seguintes habilidades neurocognitivas: capacidade intelectiva, sistema mnem?nico, aten??o, visoespacialidade e visoconstru??o, velocidade de processamento e fun??es executivas. Os dados foram analisados atrav?s de medidas descritivas e inferenciais com o aux?lio do Teste U de Mann-Whitney e do Teste t, considerando-se a influ?ncia das vari?veis: sexo, idade ao diagn?stico, tempo decorrido desde o t?rmino do tratamento e n?vel de escolariza??o das m?es, sobre o desempenho das crian?as. De forma geral, conclui-se que o adoecimento e o tratamento da leucemia linfoide aguda favorece significativamente o surgimento de d?ficits cognitivos, em especial em termos de habilidades visoespaciais, visoconstrutivas e habilidades executivas. Por sua vez, a modalidade de tratamento da radioterapia est? associada ? presen?a de d?ficits mais severos, com destaque para o impacto significativo sobre a velocidade no processamento da informa??o. Espera-se que os resultados ora apresentados venham a contribuir para uma melhor compreens?o acerca da natureza e da extens?o dos efeitos neurocognitivos advindos do tratamento da LLA

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-17T20:58:04Z No. of bitstreams: 1 DanielleFerreiraGarciaMafraCampelo_TESE.pdf: 12451781 bytes, checksum: 2d36de05d3f436e95789402636f289ad (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-18T18:19:09Z (GMT) No. of bitstreams: 1 DanielleFerreiraGarciaMafraCampelo_TESE.pdf: 12451781 bytes, checksum: 2d36de05d3f436e95789402636f289ad (MD5) / Made available in DSpace on 2017-04-18T18:19:09Z (GMT). No. of bitstreams: 1 DanielleFerreiraGarciaMafraCampelo_TESE.pdf: 12451781 bytes, checksum: 2d36de05d3f436e95789402636f289ad (MD5) Previous issue date: 2016-12-01 / O c?ncer ? a primeira causa de morte de crian?as no Brasil, com 12.600 casos estimados para 2017. Tumores de sistema nervoso central (SNC) s?o os mais comuns na inf?ncia e 60% atingem cerebelo e adjac?ncias na fossa posterior. A les?o e o tratamento impactam o SNC e altera??es em fun??es complexas v?m sendo associadas ? interrup??o de conex?es entre o cerebelo e ?reas corticais. A radioterapia, respons?vel pelo aumento da sobrevida em casos de tumores malignos, possui a??o neurot?xica sobre o SNC em desenvolvimento. O objetivo do presente estudo ? investigar o funcionamento neuropsicol?gico e acad?mico de crian?as e adolescentes sobreviventes de tumores de fossa posterior. A pesquisa foi subdividida em tr?s estudos: 1) Caracteriza??o da capacidade intelectual de pacientes pedi?tricos diagnosticados com tumores de fossa posterior; 2) Investiga??o das fun??es executivas em pacientes pedi?tricos sobreviventes de tumores de fossa posterior e; 3) Proposi??o de modelo conceitual para explicar o perfil neuropsicol?gico de crian?as e adolescentes submetidas ? radia??o craniana. 37 sujeitos com idades entre seis e 16 anos compuseram o grupo cl?nico e 24 sujeitos saud?veis compuseram grupo controle, pareados 1:1 segundo sexo, idade, tipo de escola e n?vel socioecon?mico dos participantes dos estudos 2 e 3. Os participantes passaram por avalia??o neuropsicol?gica, com resultados analisados por ferramentas estat?sticas descritivas e inferenciais e an?lise cl?nico-qualitativa. No estudo 1, crian?as submetidas ? radioterapia apresentaram desempenho significativamente inferior ao de crian?as submetidas apenas ? neurocirurgia em todos os dom?nios intelectuais, notadamente os n?o-verbais e velocidade de processamento. O dom?nio n?o verbal revelou diferen?as significativas em fun??o do tipo de tratamento, enquanto o dom?nio verbal acarretou diferen?as significativas em fun??o da escolaridade materna, revelando dissocia??o quanto aos dom?nios cognitivos mais afetados pelo tumor e pelo tratamento, e aqueles mais impactados por fatores socioculturais. Crian?as diagnosticadas tardiamente apresentaram pior desempenho, contradizendo estudos anteriores. O estudo 2 revelou altera??es executivas nos dom?nios da mem?ria de trabalho, inibi??o, flexibilidade e planejamento em ambos os grupos cl?nicos. Crian?as submetidas ? radioterapia apresentaram mais dom?nios afetados e preju?zos mais severos. Crian?as tratadas apenas com neurocirurgia apresentaram dificuldades restritas a tarefas com demandas executivas mais sofisticadas, enquanto crian?as submetidas ? radioterapia apresentaram dificuldades nestes e em tarefas mais simples. O estudo 3 apresentou importantes resultados em dire??o ? compreens?o do perfil neuropsicol?gico de crian?as submetidas ? radioterapia. Os dados sugerem que a desmieliniza??o provocada pela radioterapia acarreta altera??es t?picas de les?es do hemisf?rio direito, em padr?o semelhante ao perfil do Transtorno N?o-Verbal de Aprendizagem (TNVA). As reflex?es te?ricas resultantes da interpreta??o dos dados levaram ? proposi??o de modelo conceitual, compreensivo e sist?mico como hip?tese explicativa para a emerg?ncia do perfil neuropsicol?gico apresentado por sobreviventes de meduloblastoma. Espera-se que o estudo estimule o interesse pelo aprofundamento da compreens?o acerca das dificuldades e desafios enfrentados por essa popula??o, visando contribuir para a proposi??o de pol?ticas p?blicas que promovam a reinser??o social e acad?mica das crian?as ap?s o tratamento, bem como para a cria??o de programas de interven??o que garantam a melhoria da qualidade de vida dos sobreviventes. / Cancer is the leading cause of death among Brazilian children, and 12.600 cases are estimated for 2017. Central nervous system (CNS) tumors are the most common on childhood, from which 60% arise in cerebellum or adjacent structures of posterior fossa. The lesion and treatment affect CNS functioning, and alterations in higher order functions have been related to the interruption of important connections between the cerebellum and cortical areas. Radiotherapy is responsible for increasing survivorship in malignant tumor cases, but it also promotes neurotoxic effects to the developing CNS. This study aimed to investigate neuropsychological and academic functioning in survivors of posterior fossa tumors. The research was subdivided into three studies: 1) Description of intellectual performance of pediatric patients diagnosed with posterior fossa tumors; 2) Investigation of executive functions in pediatric survivors of posterior fossa tumors and; 3) Proposal of a conceptual model to explain the neuropsychological profile of children and adolescents submitted to cranial radiation. 37 subjects aged 6-16 integrated clinical group, and 24 subjects formed a healthy control group matched 1:1 with the participants of studies 2 and 3 according to sex, age, type of school and socioeconomic level. Participants were submitted to neuropsychological evaluation and results were analyzed through descriptive and inferential statistical tools and clinic-qualitative analysis. In the first study, children who underwent radiotherapy had significantly lower performances on intellectual domains compared to children only surgically treated, mainly in nonverbal and processing speed domains. Nonverbal domain revealed significant differences according to treatment modality, while verbal domain led to significant differences according to mother educational level, which reveals a dissociation regarding to the domains more strongly affected by the tumor and the treatment, and the domains more affected by sociocultural factors. Children diagnosed later showed lower performances, which disagree with previous studies. The second study revealed executive impairments on both clinical groups in terms of working memory, inhibition, flexibility and planning. Children submitted to radiotherapy showed a broader range of affected domains and the most serious impairments compared to children who did not undergo radiotherapy. These children showed difficulties only in measures with more sophisticated executive demands, while children submitted to radiotherapy also presented impairments in more simple executive tasks. The third study presented important results towards the comprehension of the neuropsychological profile of children submitted to cranial radiation therapy. Data suggest that demyelination caused by radiotherapy leads to right hemisphere typical impairments, in a pattern which is similar to the Nonverbal Learning Disability (NLD) profile. Theoretical reflections resulting from data interpretation led to the proposition of a conceptual, comprehensive and systemic model as an explanation hypothesis to the emergency of childhood medulloblastoma neuropsychological profile. It is expected that this study encourage research interest towards the understanding of difficulties and challenges faced by this population, in order to contribute to the creation of public policies which enable children?s social and academic reinsertion after treatment, as well as to the creation of intervention programs which ensure the improvement of survivors? quality of life.

Made available in DSpace on 2014-12-17T15:38:51Z (GMT). No. of bitstreams: 1 DanielleFG_DISSERT.pdf: 5162066 bytes, checksum: d43c54235f8f5b351fac7f8338c0b332 (MD5) 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 xxii 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.

Made available in DSpace on 2014-12-17T15:38:52Z (GMT). No. of bitstreams: 1 EdianaROG_DISSERT.pdf: 2182777 bytes, checksum: a6c802e96d340606dfb3cbb335b79787 (MD5) Previous issue date: 2011-04-01 / The present work investigated the cognitive operation of children diagnosed with acute lymphoblastic leukaemia (ALL), accompanied at pediatric oncologic institutions at the city of Natal/RN. Had participated in this study twenty children, of both sexes, between six and twelve years old, with the ALL diagnostic, who were in treatment (n=10) and out of treatment for at least one year (n=10) and were submitted exclusively to chemotherapy as CNS prophylaxis. The utilized protocol of neuropsychological evaluation covered the following cognitive abilities: intellective capability, attentional and memory systems, and executive functions. Data was analyzed through descriptive and inferential measures, with the support of the Mann-Whitney U Test and T-test, considering the influence of the variables sex, age at diagnostic and the past time since the beginning of the treatment over children s performance. The intellective capability evaluation showed low score to the out-of-treatment groups, female and children under five years old to the diagnostic. In concern of attentional systems, groups showed the expected performance. In a relevant way, in the evaluation of executive functions, were found reduced scores within all groups, especially inside the in-treatment group. Memory evaluation pointed to reduced performance in items concerning to learning evolution and spontaneous evocation after interference to the several groups. It can be concluded, reffer to the occurrence of transitory and permanent impact associated to the intrusion of chemotherapic components during the maturational course of the CNS. It s expected that the present investigation and the development of similar studies enable major comprehension about the mode, extension and repercussion of these damages subsidizing the development of strategies which may minimize them and provide better xxiii life quality to this clinical subgroup / O presente trabalho investigou o funcionamento cognitivo de crian?as diagnosticadas com Leucemia Linf?ide Aguda (LLA) acompanhadas por institui??es oncol?gicas pedi?tricas no munic?pio de Natal/RN. Participaram deste estudo 20 crian?as diagnosticadas com LLA, de ambos os sexos, com idades entre seis e doze anos, que estavam em tratamento (n=10) e fora de tratamento h? pelo menos 1 ano (n=10), submetidas exclusivamente ? quimioterapia como profilaxia do SNC. O protocolo de avalia??o neuropsicol?gica utilizado contemplou as seguintes habilidades cognitivas: capacidade intelectiva, sistemas atencionais e de mem?ria e fun??es executivas. Os dados foram analisados atrav?s de medidas descritivas e inferenciais com o aux?lio do Teste U de Mann-Whitney e do Teste t, considerando-se a influ?ncia das vari?veis sexo, idade ao diagn?stico e tempo decorrido desde o in?cio do tratamento sobre o desempenho das crian?as. A avalia??o da capacidade intelectiva revelou baixas pontua??es para os grupos fora de tratamento, sexo feminino e crian?as menores de cinco anos ao diagn?stico. Quanto aos sistemas atencionais os grupos apresentaram desempenho dentro do esperado. De forma relevante, na avalia??o das fun??es executivas foram encontradas pontua??es reduzidas em todos os grupos, com destaque para o grupo em tratamento. A avalia??o da mem?ria indicou desempenho rebaixado em itens concernentes ? evolu??o da aprendizagem e evoca??o espont?nea ap?s interfer?ncia para os diversos grupos. Conclui-se que estas informa??es aludem ? ocorr?ncia de impactos transit?rios e permanentes associados ? intrus?o de componentes quimioter?picos no curso maturacional do SNC. Espera-se que a presente investiga??o e o desenvolvimento de estudos semelhantes possibilitem maior compreens?o acerca da modalidade, extens?o e repercuss?o de tais preju?zos, subsidiando o desenvolvimento de xxi estrat?gias que possam minimiz?-los e proporcionar maior qualidade de vida para este subgrupo cl?nico