Lene Haldbo-Classen1, Ali Amidi2, Lisa M Wu3, Slavka Lukacova1, Gorm von Oettingen4, Hanne Gottrup5, Robert Zachariae2, Morten Høyer6. 1. a Department of Oncology , Aarhus University Hospital , Aarhus , Denmark. 2. b Department of Oncology and Department of Psychology and Behavioral Sciences, Unit for Psychooncology and Health Psychology , Aarhus University Hospital and Aarhus University , Aarhus , Denmark. 3. c Department of Medical Social Sciences , Northwestern University Feinberg School of Medicine , Chicago , IL , USA. 4. d Department of Neurosurgery , Aarhus University Hospital , Aarhus , Denmark. 5. e Department of Neurology , Aarhus University Hospital , Aarhus , Denmark. 6. f Center for Particle Therapy , Aarhus University Hospital , Aarhus , Denmark.
Abstract
Background: The extent of radiation therapy (RT)-induced changes in cognitive function is unknown. RT with protons instead of photons spares the healthy brain tissue more and is believed to reduce the risk of cognitive dysfunction. There is modest knowledge on which parts of the brain we need to spare, to prevent cognitive dysfunction. To uncover which cognitive domains is most affected, we compared cognitive functioning in brain tumor patients treated with neurosurgery and RT with brain tumor patients treated with neurosurgery alone. Methods: A cross-sectional study assessing cognitive function in 110 patients with a primary brain tumor grades I-III or medulloblastoma (grade IV) treated at Aarhus University Hospital (AUH), Denmark between 2006 and 2016. Two cohorts were established: a cohort of 81 brain tumor patients who had received neurosurgery followed by RT (RT+), and a cohort of 29 brain tumor patients who had only received neurosurgery (RT-). The patients underwent questionnaires and neuropsychological assessment with standardized tests. Results: Mean age was 53.5 years with an average time since diagnosis of 7.3 years. Compared with normative data, lower average scores were observed for the entire group on domains concerning of verbal learning and memory (p < .001), attention and working memory (p < .001), processing speed (p < .001), and executive functioning (p < .001). Compared to RT- patients, RT + patients scored lower on domains concerning processing speed (p = .04) and executive function (p = .05) and had higher impairment frequency on verbal fluency (p = .02) with 16% of patients exceeding 1.5 SD below normative data. Conclusions: Our results indicate that treatment, including RT, for a primary brain tumor may have negative long-term impact on cognitive function, especially on processing speed and executive function.
Background: The extent of radiation therapy (RT)-induced changes in cognitive function is unknown. RT with protons instead of photons spares the healthy brain tissue more and is believed to reduce the risk of cognitive dysfunction. There is modest knowledge on which parts of the brain we need to spare, to prevent cognitive dysfunction. To uncover which cognitive domains is most affected, we compared cognitive functioning in brain tumorpatients treated with neurosurgery and RT with brain tumorpatients treated with neurosurgery alone. Methods: A cross-sectional study assessing cognitive function in 110 patients with a primary brain tumor grades I-III or medulloblastoma (grade IV) treated at Aarhus University Hospital (AUH), Denmark between 2006 and 2016. Two cohorts were established: a cohort of 81 brain tumorpatients who had received neurosurgery followed by RT (RT+), and a cohort of 29 brain tumorpatients who had only received neurosurgery (RT-). The patients underwent questionnaires and neuropsychological assessment with standardized tests. Results: Mean age was 53.5 years with an average time since diagnosis of 7.3 years. Compared with normative data, lower average scores were observed for the entire group on domains concerning of verbal learning and memory (p < .001), attention and working memory (p < .001), processing speed (p < .001), and executive functioning (p < .001). Compared to RT- patients, RT + patients scored lower on domains concerning processing speed (p = .04) and executive function (p = .05) and had higher impairment frequency on verbal fluency (p = .02) with 16% of patients exceeding 1.5 SD below normative data. Conclusions: Our results indicate that treatment, including RT, for a primary brain tumor may have negative long-term impact on cognitive function, especially on processing speed and executive function.
Authors: Pauline Brummelman; Margriet G A Sattler; Linda C Meiners; Martin F Elderson; Robin P F Dullaart; Gerrit van den Berg; Janneke Koerts; Oliver Tucha; Bruce H R Wolffenbuttel; Alfonsus C M van den Bergh; André P van Beek Journal: Eur J Endocrinol Date: 2011-11-09 Impact factor: 6.664
Authors: Kathleen F Tennant; Steven E Takacs; Jen-Tzer Gau; Brian C Clark; David W Russ Journal: Aging Clin Exp Res Date: 2011-10-24 Impact factor: 3.636
Authors: Linda Douw; Martin Klein; Selene Saa Fagel; Josje van den Heuvel; Martin Jb Taphoorn; Neil K Aaronson; Tjeerd J Postma; W Peter Vandertop; Jacob J Mooij; Rudolf H Boerman; Guus N Beute; Jasper D Sluimer; Ben J Slotman; Jaap C Reijneveld; Jan J Heimans Journal: Lancet Neurol Date: 2009-08-07 Impact factor: 44.182
Authors: M Klein; J J Heimans; N K Aaronson; H M van der Ploeg; J Grit; M Muller; T J Postma; J J Mooij; R H Boerman; G N Beute; G J Ossenkoppele; G W van Imhoff; A W Dekker; J Jolles; B J Slotman; H Struikmans; M J B Taphoorn Journal: Lancet Date: 2002-11-02 Impact factor: 79.321
Authors: Amanda D Hutchinson; Jessica R Hosking; Ganessan Kichenadasse; Julie K Mattiske; Carlene Wilson Journal: Cancer Treat Rev Date: 2012-06-02 Impact factor: 12.111
Authors: Carol A Hahn; Su-Min Zhou; Renee Raynor; Andrea Tisch; Kim Light; Timothy Shafman; Terence Wong; John Kirkpatrick; Timothy Turkington; Donna Hollis; Lawrence B Marks Journal: Int J Radiat Oncol Biol Phys Date: 2008-08-26 Impact factor: 7.038
Authors: Angela Sekely; Derek S Tsang; Donald Mabbott; Paul Kongkham; Gelareh Zadeh; Konstantine K Zakzanis; Kim Edelstein Journal: Neurooncol Pract Date: 2022-02-19
Authors: Sé Maria Frances; Galina Velikova; Martin Klein; Susan C Short; Louise Murray; Judy M Wright; Florien Boele Journal: Neurooncol Pract Date: 2021-11-10
Authors: L Haldbo-Classen; A Amidi; L M Wu; S Lukacova; G Oettingen; Y Lassen-Ramshad; R Zachariae; J F Kallehauge; M Høyer Journal: Clin Transl Radiat Oncol Date: 2021-09-27
Authors: Varna Jammula; James L Rogers; Elizabeth Vera; Alexa Christ; Heather E Leeper; Alvina Acquaye; Nicole Briceno; Anna Choi; Ewa Grajkowska; Jason E Levine; Matthew Lindsley; Jennifer Reyes; Kayla N Roche; Michael Timmer; Lisa Boris; Eric Burton; Nicole Lollo; Marissa Panzer; Matthew A Smith-Cohn; Marta Penas-Prado; Valentina Pillai; Brett J Theeler; Jing Wu; Mark R Gilbert; Terri S Armstrong Journal: Neurooncol Pract Date: 2022-05-14
Authors: Tamara Ownsworth; Katarzyna Lion; Ursula M Sansom-Daly; Kerryn Pike; Eng-Siew Koh; Georgia K B Halkett; Mark B Pinkham; Raymond J Chan; Haryana M Dhillon Journal: Psychooncology Date: 2022-04-02 Impact factor: 3.955