Angela Sekely1,2, Derek S Tsang3,4, Donald Mabbott5,6, Paul Kongkham3,7, Gelareh Zadeh7, Konstantine K Zakzanis1,5, Kim Edelstein1,2,8. 1. Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, Ontario, Canada. 2. Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada. 3. Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada. 4. Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada. 5. Department of Psychology, University of Toronto, Toronto, Ontario, Canada. 6. Department of Psychology, Neurosciences, and Mental Health Program, The Hospital for Sick Children, Toronto, Ontario, Canada. 7. Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Toronto, Ontario, Canada. 8. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Abstract
Background: Although radiation (RT) is standard treatment for many brain tumors, it may contribute to neurocognitive decline. The objective of this study was to investigate associations between RT dose to circumscribed brain regions and specific neurocognitive domains in patients with meningioma. Methods: We undertook a retrospective study of 40 patients with meningioma who received RT and underwent an in-depth clinical neurocognitive assessment. Radiation dosimetry characteristics were delineated based on treatment planning computerized tomography co-registered with contrast-enhanced 3D T1-weighted magnetic resonance imaging. Principal components analysis was applied to organize neurocognitive test scores into factors, and multivariate multiple linear regression models were undertaken to examine if RT dose to circumscribed brain regions is associated with specific neurocognitive outcomes. Results: Radiation dose to brain regions was associated with neurocognitive functions across a number of domains. High dose to the parietal-occipital region was associated with slower visuomotor processing speed (mean dose, β = -1.100, P = .017; dose to 50% of the region [D50], β = -0.697, P = .049). In contrast, high dose to the dorsal frontal region was associated with faster visuomotor processing speed (mean dose, β = 0.001, P = .036). Conclusions: These findings suggest that RT delivered to brain regions (ie, parietal-occipital areas) may contribute to poor neurocognitive outcomes. Given that modern radiotherapy techniques allow for precise targeting of dose delivered to brain regions, prospective trials examining relations between dose and neurocognitive functions are warranted to confirm these preliminary results.
Background: Although radiation (RT) is standard treatment for many brain tumors, it may contribute to neurocognitive decline. The objective of this study was to investigate associations between RT dose to circumscribed brain regions and specific neurocognitive domains in patients with meningioma. Methods: We undertook a retrospective study of 40 patients with meningioma who received RT and underwent an in-depth clinical neurocognitive assessment. Radiation dosimetry characteristics were delineated based on treatment planning computerized tomography co-registered with contrast-enhanced 3D T1-weighted magnetic resonance imaging. Principal components analysis was applied to organize neurocognitive test scores into factors, and multivariate multiple linear regression models were undertaken to examine if RT dose to circumscribed brain regions is associated with specific neurocognitive outcomes. Results: Radiation dose to brain regions was associated with neurocognitive functions across a number of domains. High dose to the parietal-occipital region was associated with slower visuomotor processing speed (mean dose, β = -1.100, P = .017; dose to 50% of the region [D50], β = -0.697, P = .049). In contrast, high dose to the dorsal frontal region was associated with faster visuomotor processing speed (mean dose, β = 0.001, P = .036). Conclusions: These findings suggest that RT delivered to brain regions (ie, parietal-occipital areas) may contribute to poor neurocognitive outcomes. Given that modern radiotherapy techniques allow for precise targeting of dose delivered to brain regions, prospective trials examining relations between dose and neurocognitive functions are warranted to confirm these preliminary results.
Authors: Ying Sun; Xiao-Li Yu; Wei Luo; Anne W M Lee; Joseph Tien Seng Wee; Nancy Lee; Guan-Qun Zhou; Ling-Long Tang; Chang-Juan Tao; Rui Guo; Yan-Ping Mao; Rong Zhang; Ying Guo; Jun Ma Journal: Radiother Oncol Date: 2014-04-07 Impact factor: 6.280
Authors: Ann M Peiffer; C Marc Leyrer; Dana M Greene-Schloesser; Elaine Shing; William T Kearns; William H Hinson; Stephen B Tatter; Edward H Ip; Stephen R Rapp; Mike E Robbins; Edward G Shaw; Michael D Chan Journal: Neurology Date: 2013-02-06 Impact factor: 9.910
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