Intellectual and Behavioral Impairment after Chemotherapy and Radiotherapy among Children with Cancer in Iran

Objective: It is well established that treatment modalities against cancer have psychosocial and serious medicalside effects especially neurologic, learning, and intellectual disorders among children with cancer. The aim ofthis study was to evaluate the behavioral change specially the effect of chemotherapy and cranial radiotherapyon the development of attention deficit hyperactivity disorder (ADHD) in children with cancer.Materials and
Methods: The children diagnosed with cancer and referred to Mahak Hospital (a well fundedcharity organization helping children with cancer in Iran) participated in this study. To assess the post treatmentbehavior, the Conner’s’ Rating Scales (CRS) questionnaire, which its reliability and validity has been wellestablished was administrated by trained interviewer in a two hour sessions to mother or attending nurses of thecases. The relationship between attention deficits, hyperactivity disorder were assessed with different categoriesof treatment, socio-economic status, age at diagnosis, sex, as well as duration since treatment.
Results: Duringperiods of six months, 30 subjects (16 male and 14 female) were studied and participated in the study. Fifteencases had both radiotherapy as well as chemotherapy and 15 cases just had chemotherapy as their treatmentregiment. The mean Conner’s Rating Score (total score of ADHD) were higher among those who received bothchemotherapy and radiotherapy compared with those who had just chemotherapy but it was not statisticallysignificant (34.7±12.6 for just chemotherapy and 39.3±9.0 for chemo and radiotherapy together). The totalConner’s Rating Score was higher among girls compared to boys (mean ± standard deviation was 39.8±9.4 forgirls and 33.7±12 for boys). Duration since treatment, age diagnosis, and mother’s level of education had effectin post treatment intellectual capacity and behavioral aspect of patients.
Conclusion: In the light of dramaticimprovement of survival among children with cancer the intellectual and behavioral impairment due to treatmentmodalities needs serious attention and proper medical management.