Adjuvant Chemotherapy for Breast Cancer: Effects on Cerebral White Matter Seen in Diffusion Tensor Imaging

Abraham, Jame; Haut, Marc W.; Morán, María Teresa Cabero; Filburn, Shannon; Lemiuex, Susan; Kuwabara, Hiroto

doi:10.3816/cbc.2008.n.007

Cited by 137 publications

(108 citation statements)

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“…Up till now three studies have reported adverse effects of chemotherapy on white matter as measured with diffusion tensor imaging (DTI) [4][5][6]. Therefore, it might be that the small effects of chemotherapy on total gray matter volume may be accompanied by microstructural whitematter changes.…”

Section: Discussionmentioning

confidence: 99%

“…Compared to healthy controls and breast cancer patients who never received cytotoxic treatment, chemotherapy-exposed patients had more white matter hyperintensities [2,3] and decreased integrity of major white matter tracts in frontal and temporal regions of the brain [4,5]. The integrity of the genu of the corpus callosum also was lower in chemotherapy-exposed patients [6].…”

Section: Introductionmentioning

confidence: 97%

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Global and focal brain volume in long-term breast cancer survivors exposed to adjuvant chemotherapy

Koppelmans

Ruiter

Lijn

et al. 2011

Breast Cancer Res Treat

152

113

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A limited number of studies have associated adjuvant chemotherapy with structural brain changes. These studies had small sample sizes and were conducted shortly after cessation of chemotherapy. Results of these studies indicate local gray matter volume decrease and an increase in white matter lesions. Up till now, it is unclear if non-CNS chemotherapy is associated with long-term structural brain changes. We compared focal and total brain volume (TBV) of a large set of non-CNS directed chemotherapy-exposed breast cancer survivors, on average 21 years post-treatment, to that of a population-based sample of women without a history of cancer. Structural MRI (1.5T) was performed in 184 chemotherapy-exposed breast cancer patients, mean age 64.0 (SD = 6.5) years, who had been diagnosed with cancer on average 21.1 (SD = 4.4) years before, and 368 age-matched cancer-free reference subjects from a population-based cohort study. Outcome measures were: TBV and total gray and white matter volume, and hippocampal volume. In addition, voxel based morphometry was performed to analyze differences in focal gray matter. The chemotherapy-exposed breast cancer survivors had significantly smaller TBV (-3.5 ml, P = 0.019) and gray matter volume (-2.9 ml, P = 0.003) than the reference subjects. No significant differences were observed in white matter volume, hippocampal volume, or local gray matter volume. This study shows that adjuvant chemotherapy for breast cancer is associated with long-term reductions in TBV and overall gray matter volume in the absence of focal reductions. The observed smaller gray matter volume in chemotherapy- 123Breast Cancer Res Treat (2012) 132:1099-1106 DOI 10.1007/s10549-011-1888-1 exposed survivors was comparable to the effect of almost 4 years of age on gray matter volume reduction. These volume differences might be associated with the slightly worse cognitive performance that we observed previously in this group of breast cancer survivors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Global and focal brain volume in long-term breast cancer survivors exposed to adjuvant chemotherapy

Koppelmans

Ruiter

Lijn

et al. 2011

Breast Cancer Res Treat

152

113

View full text Add to dashboard Cite

show abstract

“…[5][6][7] Recent studies have investigated the effects of chemotherapy and radiation on global and regional brain anatomy using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI). [8][9][10][11][12][13][14][15][16][17][18][19] While the design and results of these studies vary, they collectively suggest that CNS toxicity is associated with cancer therapy even for non-CNS malignancies, with widespread gray matter (GM) and white matter (WM) loss, and associated deficits in multiple cognitive domains. 15,16 Few studies, however, have examined the extended time course of these effects, and none has assessed longitudinal changes on MRI in patients receiving chemotherapy and cranial RT.…”

mentioning

confidence: 98%

Standard chemoradiation for glioblastoma results in progressive brain volume loss

et al. 2015

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“…Algunos datos sostienen que el deterioro cognitivo detectado por las imágenes de resonancia magnética se correlacionan con el deterioro cognitivo percibido pero no con los resultados de los test clásicos (46) ; también se objetiva más hipertensión en la sustancia blanca, y mayor extensión de actividad cerebral en la realización de una tarea de memoria (45) y menor sustancia gris y blanca en los giros prefrontal, parahipocampal y cingulado en las mujeres que sufrieron cáncer de mama tratadas con quimioterapia (47) . De igual forma, mediante resonancia magnética se han encontrado daños en la actividad del córtex frontal, el cerebelo y los ganglios basales en mujeres de cáncer de mama que habían recibido quimioterapia hacía 5-10 años (48) ; la quimioterapia puede afectar a la sustancia blanca del cuerpo calloso (49) y a la sustancia gris cortical (50) . Mediante encefalograma, se observan alteraciones electrofisiológicas en los potenciales P3 en personas con cáncer de mama tratadas con dosis altas de quimioterapia hacía 4 años (51) .…”

Section: Instrumentos Y Estrategias De Evaluación Del Rendimiento Cogunclassified

Chemobrain: revisión de estudios que evalúan el deterioro cognitivo de supervivientes de cáncer tratados con quimioterapia

2012

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The problem: Some cancer patients have expressed attention, concentration and memory problems, during and after their treatment with chemotherapy, also called chemobrain. Following these complains, in recent decades, studies about this adverse effect had increased.Development of the topic: this work aims to review and analyze the latest scientific studies investigating the nature and severity of cognitive impairment associated with chemotherapy treatments. Works discussed are drowned from different bibliographical sources, mainly from the PubMed database. Results show that, in recent years, longitudinal studies have increased, chemobrain is being studied above all in samples from women with breast cancer, research in other types of cancer is insufficient. Also, the works include new assessment tools, such as MRI and EEG. Advances are done with animal experiments, in vivo and in vitro. Finally, we found studies on drugs and effective strategies for coping of cognitive impairment. The development of guidelines for its systematic study and recommendations for its approach are still pending.Conclusion: There is not conclusive data on the chemobrain, longitudinal studies should be encouraged, as well as assessing the cognitive impact of certain chemotherapeutic agents in different cancers. The works on cognitive Resumen Planteamiento del problema: Algunos pacientes oncológicos han expresado problemas de atención, concentración y memoria durante y después de los tratamientos con quimioterapia, a los que se ha llamado chemobrain. Como consecuencia de estas manifestaciones, en las últimas décadas los estudios dedicados a indagar este posible efecto adverso se han incrementado.Desarrollo del tema: Este trabajo pretende revisar y analizar los estudios científicos más recientes que investigan la naturaleza y alcance del daño cognitivo asociado a los tratamientos quimioterapéuticos. Los artículos analizados se han extraído de diferentes fuentes bibliográficas, principalmente de la base de datos PubMed. Como resultado de la búsqueda se aprecia que, en los últimos años, se han incremento los estudios de diseño longitudinal; este posible efecto adverso se sigue estudiando sobre todo en muestras de mujeres con cáncer de mama, las investigaciones en otros tipos de cánceres son insuficientes; así mismo, destaca la inclusión de nuevas herramientas de evaluación, como la resonancia magnética y el electroencefalograma, junto con nuevos experimentos realizados con animales, in vivo e in vitro, finalmente se constata la inclusión de algunos estudios sobre fármacos y estrategias eficaces para su afrontamiento. La elaboración de guías para el estudio sistemático y las re-

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Adjuvant Chemotherapy for Breast Cancer: Effects on Cerebral White Matter Seen in Diffusion Tensor Imaging

Cited by 137 publications

References 20 publications

Global and focal brain volume in long-term breast cancer survivors exposed to adjuvant chemotherapy

Global and focal brain volume in long-term breast cancer survivors exposed to adjuvant chemotherapy

Standard chemoradiation for glioblastoma results in progressive brain volume loss

Chemobrain: revisión de estudios que evalúan el deterioro cognitivo de supervivientes de cáncer tratados con quimioterapia

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