Neurocognitive Implications in Children Undergoing Chemotherapy and Radiotherapy

Background: Radiotherapy and chemotherapy drugs were essential for increasing the survival rates of pediatric cancer patients, but dysfunctions associated with treatment, mainly neurological and cognitive, are recorded and should be considered in deciding the therapeutic plan. Objectives: Analyze the current literature on the neurocognitive effects in children undergoing chemotherapy and radiation therapy. Methods: A bibliographic review was carried out in the MEDLINE / Pubmed and LILACS databases, using the terms “cognitive effects”, “chemotherapy”, “radiotherapy” and “child”, in Portuguese and in English. 79 articles were found and 6 followed for complete analysis. Articles published more than 5 years ago and that did not address the proposed subject were not used. Results: Radiotherapy, especially cranial (CRT), is associated with serious effects, such as induction of vasculopathy, stroke, cerebrovascular malformations, in addition to an increased risk for subsequent malignant CNS tumors. Despite being a standard treatment for several neoplasms, radiotherapy has been replaced, when possible, by higher doses of chemotherapy, which has a considerable level of neurotoxicity, capable of causing coagulopathy, encephalopathy, seizures and neuropathies, both sensory and motor. However, deficits in children’s attentional capacity in both treatment categories stood out, sometimes implying educational difficulties and decline in non-verbal skills. Conclusions: Although chemotherapy and radiation therapy represent impressive advances, their consequences remain a concern. Future studies should seek strategies for prevention, early recognition and management of neurotoxicity, in order to promote better life quality for patients.