Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review
Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review
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TY - JOUR
T1 - Long-term cognitive dysfunction after radiation therapy for primary brain tumors
AU - Haldbo-Classen, Lene
AU - Amidi, Ali
AU - Wu, Lisa M
AU - Lukacova, Slavka
AU - Oettingen, Gorm von
AU - Gottrup, Hanne
AU - Zachariae, Robert
AU - Høyer, Morten
PY - 2019
Y1 - 2019
N2 - 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.
AB - 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.
KW - CANCER
KW - DEFICITS
KW - IMPAIRMENT
KW - LOW-GRADE GLIOMAS
KW - QUALITY-OF-LIFE
KW - RADIOTHERAPY
UR - http://www.scopus.com/inward/record.url?scp=85061515831&partnerID=8YFLogxK
U2 - 10.1080/0284186X.2018.1557786
DO - 10.1080/0284186X.2018.1557786
M3 - Journal article
C2 - 30757955
VL - 58
SP - 745
EP - 752
JO - Acta Oncologica
JF - Acta Oncologica
SN - 0284-186X
IS - 5
ER -