Introduction
We investigated multi-domain baseline neurocognition of primary brain tumor patients prior to radiotherapy (RT), including clinical predictors of function and association between pre-RT and post-RT impairment on a prospective trial.
#2Tanya T. Nguyen(UCSD: University of California, San Diego)H-Index: 16
Last. Carrie R. McDonald(UCSD: University of California, San Diego)H-Index: 38
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Abstract Background and purpose Executive function (EF) decline is common after brain radiation therapy (RT), yet the etiology is unclear. We analyzed the association between longitudinal changes in frontal lobe white matter microstructure and decline in EF following RT in brain tumor patients on a prospective clinical trial. Materials and methods Diffusion tensor imaging was obtained on 22 patients with brain tumors prior to RT, as well as 3- and 6-months post-RT, in a prospective, observationa...
Abstract Life expectancy of patients treated for brain tumors has lengthened due to the therapeutic improvements. Cognitive impairment has been described following brain radiotherapy, but the mechanisms leading to this adverse event remain mostly unknown. Technical evolutions aim at enhancing the therapeutic ratio. Sparing of the healthy tissues has been improved using various approaches; however, few dose constraints have been established regarding brain structures associated with cognitive fun...
Abstract Background and purpose Incidental irradiation of normal brain tissue during radiotherapy is linked to cognitive decline, and may be mediated by damage to healthy cortex. Non-coplanar techniques may be used for cortical sparing. We compared normal brain sparing and probability of cortical atrophy using 4π radiation therapy planning vs. standard fixed gantry intensity-modulated radiotherapy (IMRT). Material and methods Plans from previously irradiated brain tumor patients (“original IMRT”...
Abstract Background and purpose To prospectively evaluate hippocampal radiation dose volume effects and memory decline following cranial irradiation. Material and methods Effects of hippocampal radiation over a wide range of doses were investigated by combining data from three prospective studies. In one, adults with small cell lung cancer received hippocampal-avoidance prophylactic cranial irradiation. In the other two, adults with glioblastoma multiforme received neural progenitor cell sparing...
#1Kyle R. Noll(University of Texas MD Anderson Cancer Center)H-Index: 10
#2Mariana E. Bradshaw(University of Texas MD Anderson Cancer Center)H-Index: 4
Last. Jeffrey S. Wefel(University of Texas MD Anderson Cancer Center)H-Index: 30
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Objective While neurocognitive functioning (NCF) and mood disturbance share a relationship with health-related quality of life (HRQOL), few studies have examined relationships between these constructs in glioma patients prior to treatment. Methods Newly diagnosed patients with glioma in the left (N = 73; 49% glioblastoma) or right (N = 30; 57% glioblastoma) temporal lobe completed neuropsychological testing and self-report measures of HRQOL (Functional Assessment of Cancer Therapy (FACT)-General...
The majority of patients who receive radiotherapy for brain tumours go on to develop disability, but the pathophysiological mechanisms of radiation-associated cognitive decline remains poorly understood. Here, Makale and colleagues review animal model and patient data on the mechanisms of radiotherapy-associated CNS damage and posit that early damage — occurring before 6 months after irradiation — contributes to long-term cognitive disability.
Last. Yue Cao(UM: University of Michigan)H-Index: 43
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Abstract Purpose/objectives Radiation injury to parahippocampal cingulum white matter is associated with cognitive decline. Diffusion tensor imaging (DTI) detects micropathologic changes in white matter. Increased radial diffusion (RD) and decreased axial diffusion (AD) correspond to demyelination and axonal degeneration/gliosis respectively. We aimed to develop a predictive model for radiation-induced cognitive changes based upon DTI changes. Materials/methods Twenty-seven adults with benign or...
Abstract Background and purpose Neurocognitive decline in brain tumor patients treated with radiotherapy (RT) may be linked to cortical atrophy. We developed models to determine radiation treatment-planning objectives for cortex, which were tested on a sample population to identify the dosimetric cost of cortical sparing. Material and methods The relationship between the probability of cortical atrophy in fifteen high-grade glioma patients at 1-year post-RT and radiation dose was fit using logis...
LBA4 Background: WBRT significantly improves tumor control in the brain after SRS, yet the role of adjuvant WBRT remains undefined due to concerns regarding neurocognitive risks. Methods: Patients with 1-3 brain metastases, each 1 SD from baseline in any of the 6 cognitive tests at 3 months. Time to CP was estimated using cumulative incidence adjusting for survival as a competing risk. Results: 213 patients were enrolled with 2 ineligible and 3 cancels prior to receiving treatment. Baseline char...
Glioma comprises the vast majority of all malignant primary brain tumors.1 These tumors often disrupt cerebral function through direct mechanisms such as destruction of brain tissue, as well as more indirect means, including compression, displacement, and ischemia.2 As a result, most patients exhibit some impairment of neurocognitive function (NCF), even early in the disease course.3,4 However, when compared with patients with acute lesions related to stroke or trauma, individuals with brain tum...
#4Mia A Salans(UCSD: University of California, San Diego)H-Index: 3
#5Kathryn R. Tringale(MSK: Memorial Sloan Kettering Cancer Center)H-Index: 11
Abstract Background The corpus callosum (CC) and intra-hemispheric white matter tracts (IHWM) subserve critical aspects of attention and processing speed. We analyzed imaging biomarkers of microstructural injury within these regions and association with attention/processing speed decline post-radiotherapy in primary brain tumor patients. Methods On a prospective clinical trial, 44 primary brain tumor patients underwent cognitive testing and MRI/diffusion-weighted imaging pre-radiotherapy, and 3-...
Abstract Life expectancy of patients treated for brain tumors has lengthened due to the therapeutic improvements. Cognitive impairment has been described following brain radiotherapy, but the mechanisms leading to this adverse event remain mostly unknown. Technical evolutions aim at enhancing the therapeutic ratio. Sparing of the healthy tissues has been improved using various approaches; however, few dose constraints have been established regarding brain structures associated with cognitive fun...
