Abstract:
PURPOSE:Post-operative radiation therapy for brain metastases (BM) has become standard treatment. Concerns regarding the deleterious cognitive effects of Whole Brain Radiation Therapy spurred a trend to use focal therapies such as stereotactic radiosurgery (SRS). The purpose of this study was to prospectively evaluate the neuropsychological effects following post-resection SRS treatment since limited data exist in this context. METHODS:We conducted a prospective single arm cohort study of patients with 1-2 BM, who underwent resection of a single BM between May 2015 to December 2016. Patients were evaluated for cognitive functions (NeuroTrax computerized neuropsychological battery; Modiin, Israel) and quality of life (QOL; QLQ-30, QLQ-BN20) before and 3 months following post-resection SRS. RESULTS:Twelve out of 14 patients completed pre- and post-SRS neurocognitive assessments. Overall, we did not detect significant neurocognitive or QOL changes 3 months following SRS. In a subgroup analysis among patients younger than 60 years, median global cognitive score increased from a pre-treatment score of 88 (72-102) to 95 (79-108), 3 months following SRS treatment, p = 0.042; Wilcoxon paired non-parametric test. Immediate verbal memory and executive functions scores increased from 86 (72-98) to 98 (92-112) and 86 (60-101) to 100 (80-126), respectively, p = 0.043. No significant cognitive changes were discovered among patients at the age of 60 or older. CONCLUSIONS:Post-resection radiosurgery has a safe neuro-cognitive profile and is associated with preservation of nearly all quality of life parameters. Patients younger than 60 years benefit most and may even regain some cognitive functions within a few months after treatment.
journal_name
J Neurooncoljournal_title
Journal of neuro-oncologyauthors
Berger A,Strauss I,Ben Moshe S,Corn BW,Limon D,Shtraus N,Shahar T,Kanner AAdoi
10.1007/s11060-018-2954-xsubject
Has Abstractpub_date
2018-11-01 00:00:00pages
307-315issue
2eissn
0167-594Xissn
1573-7373pii
10.1007/s11060-018-2954-xjournal_volume
140pub_type
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journal_title:Journal of neuro-oncology
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journal_title:Journal of neuro-oncology
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journal_title:Journal of neuro-oncology
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journal_title:Journal of neuro-oncology
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更新日期:1994-01-01 00:00:00
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journal_title:Journal of neuro-oncology
pub_type: 临床试验,杂志文章
doi:10.1023/a:1012554328801
更新日期:2001-08-01 00:00:00
abstract::Radiotherapy (RT) and concomitant/adjuvant therapy with temozolomide (Temodar) is a common treatment regimen for children and adults with glioma. Although temozolomide is generally well tolerated with temporary myelosuppression as the primary dose-limiting toxicity, irreversible bone-marrow aplasia after treatment wit...
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journal_title:Journal of neuro-oncology
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journal_title:Journal of neuro-oncology
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