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O impacto da radioterapia no desenvolvimento cognitivo em doentes pediátricos com tumores do sistema nervoso central: revisão sistemática
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Abstract(s)
Introdução – Os tumores do sistema nervoso central (SNC) são a segunda patologia maligna mais comum e a principal causa de morte por cancro em crianças e adolescentes com menos de vinte anos. Apesar dos avanços terapêuticos terem aumentado a taxa de sobrevivência aos cinco anos para cerca de 80%, os tratamentos ainda causam efeitos secundários agudos e tardios. Entre os efeitos agudos da radioterapia (RT) estão fadiga, náuseas, vómitos e cefaleias, enquanto os efeitos tardios incluem défices neurológicos e cognitivos que afetam a qualidade de vida. Este estudo analisa os efeitos secundários tardios cognitivos da RT em doentes pediátricos com tumores do SNC, uma área ainda pouco explorada na literatura científica. Objetivos – Identificar os efeitos cognitivos e compreender o seu impacto no desenvolvimento de doentes pediátricos com tumores do SNC, sujeitos a tratamento de RT. Métodos – De acordo com as recomendações do Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) realizou-se uma revisão sistemática da literatura. A pesquisa de literatura científica foi realizada em dezembro de 2023 nas bases de dados PubMed/MEDLINE, Scopus e Web of Science, de acordo com os critérios de inclusão e exclusão definidos pelo PEOS. Resultados – Obteve-se um total de 25 artigos que demonstram alterações a nível cognitivo no desempenho académico e no QI. Para além destas, identificaram-se outras alterações, como as endócrinas e a perda auditiva. Considerações finais – A RT tem impacto no desenvolvimento e na qualidade de vida dos doentes, levando ao aparecimento de vários efeitos cognitivos tardios. Os efeitos identificados são: défices neuropsicológicos, neurocognitivos, cognitivos, na função executiva, intelectual, dificuldades de integração social, na realização das atividades diárias, pior aproveitamento académico, velocidade de processamento, memória, problemas de atenção e um menor QI.
ABSTRACT Introduction – Central nervous system (CNS) tumors are the second most common malignancy and the leading cause of cancer-related death in children and adolescents under the age of 20 years. Although therapeutic advances have increased the 5-year survival rate to approximately 80 percent, treatments still cause acute and late adverse effects. The acute effects of radiotherapy (RT) include fatigue, nausea, vomiting, and headaches, while late effects include neurological and cognitive deficits affecting quality of life. This study analyzed the late cognitive side effects of RT in pediatric patients with tumors of the central nervous system, an area that has not been explored in the scientific literature. Objectives – To identify the cognitive effects and understand their impact on the development of central nervous system tumors in pediatric patients undergoing RT. Methods – A systematic literature review was conducted following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and a systematic literature review was carried out. The search for scientific literature was carried out in December 2023 in the PubMed/MEDLINE, Scopus, and Web of Science databases according to the inclusion and exclusion criteria defined by PEOS. Results – A total of 25 articles were obtained, demonstrating changes in cognitive level, academic performance, and IQ. In addition, other factors, such as endocrine alterations and hearing loss, were identified. Conclusion – RT impacts the development and quality of life of patients, leading to various late cognitive effects. The identified impacts were neuropsychological, neurocognitive, cognitive, and intellectual deficits, in executive function, difficulties in social integration, and carrying out daily activities, worse academic performance, processing speed, memory, attention problems, and a lower IQ.
ABSTRACT Introduction – Central nervous system (CNS) tumors are the second most common malignancy and the leading cause of cancer-related death in children and adolescents under the age of 20 years. Although therapeutic advances have increased the 5-year survival rate to approximately 80 percent, treatments still cause acute and late adverse effects. The acute effects of radiotherapy (RT) include fatigue, nausea, vomiting, and headaches, while late effects include neurological and cognitive deficits affecting quality of life. This study analyzed the late cognitive side effects of RT in pediatric patients with tumors of the central nervous system, an area that has not been explored in the scientific literature. Objectives – To identify the cognitive effects and understand their impact on the development of central nervous system tumors in pediatric patients undergoing RT. Methods – A systematic literature review was conducted following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and a systematic literature review was carried out. The search for scientific literature was carried out in December 2023 in the PubMed/MEDLINE, Scopus, and Web of Science databases according to the inclusion and exclusion criteria defined by PEOS. Results – A total of 25 articles were obtained, demonstrating changes in cognitive level, academic performance, and IQ. In addition, other factors, such as endocrine alterations and hearing loss, were identified. Conclusion – RT impacts the development and quality of life of patients, leading to various late cognitive effects. The identified impacts were neuropsychological, neurocognitive, cognitive, and intellectual deficits, in executive function, difficulties in social integration, and carrying out daily activities, worse academic performance, processing speed, memory, attention problems, and a lower IQ.
Description
Keywords
Radioterapia Pediatria Sistema nervoso central Tumores cerebrais Efeitos cognitivos Quociente de inteligência Radiotherapy Pediatrics Central nervous system Brain tumors Cognitive effects IQ
Citation
Caetano M, Correia R, Martins R. O impacto da radioterapia no desenvolvimento cognitivo em doentes pediátricos com tumores do sistema nervoso central: revisão sistemática. Saúde & Tecnologia. 2024;(30):e835.
Publisher
Instituto Politécnico de Lisboa