PSYCHOLOGICAL ASSESSMENT IN CHILDREN WITH TUMORS OF POSTERIOR FOSSA: FROM DIAGNOSIS TO FOLLOW UP

Lesions of the posterior fossa account for 20 % of all the patients with brain tumors and although tumor related neuropsychological sequelae have been reported, few data describe the psychosocial consequences faced at the end of the treatment. We assessed emotional, behavioral and social impairments from diagnosis to follow-up (6-12 months), in children referred to our institution, using the Achenbach Child Behavior Checklist for ages 1-5 years (group-1) and 6-18 years (group-2). The possible correlation between impairments and tumor’s location was also evaluated. We enrolled 23 patients (14 M, 9 F), 11 (48%) in group-1 and 12 (52%) in group-2. Mean age was 89 months at diagnosis and 101 months at follow-up. The lo- cation was vermian in 8 patients (35%); emispheric in 2 (9%), vermian-emispheric in 3 (13%) and extending to the fourth ventricle in 3 (13%). Most frequent histology was medulloblastoma (74%), followed by pilocytic astrocytoma (18%) and ependymoma (8%). All the patients under- went surgical resection, 14 patients (61%) received chemotherapy, 8 (35%) chemotherapy and radiotherapy. Mean Internalizing scores were 52 at diag- nosis and 53 at first follow up in group-1, 57 and 64 respectively in group-2. Mean Externalizing scores were 47 and 53 for younger children and 46 and 51 for the other group (diagnosis and follow-up, respectively). Changes of emotional, behavioral and social profiles were not found to be significant in both groups. A trend toward increase of attention issues was found in patients with lesions involving the fourth ventricle. Our preliminary data suggest that emotional, behavioral or social impairments at diagnosis tend to stably persist throughout treatment and must then be target of early interven- tion. Moreover, specific neuropsychological rehabilitation might be benefi- cial in case of lesions involving the fourth ventricle. A larger cohort of patients and longer follow-up are required to better characterize our results.