Cognitive Function Before and After Intensity-Modulated Radiation Therapy in Patients With Nasopharyngeal Carcinoma: A Prospective Study

Hsiao, Kuan-Yin; Yeh, Shyh-An; Chang, Chiung‐Chih; Tsai, Pei‐Chien; Wu, Jiaming; Gau, Jhy-Shyan

doi:10.1016/j.ijrobp.2009.06.080

Cited by 141 publications

(125 citation statements)

References 45 publications

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“…Data on neurocognitive functioning in patients with head and neck cancer (HNC) are primarily limited to eight small studies [8][9][10][11][12][13][14][15]. Six studies [8][9][10][11][12][13] evaluated the neurocognitive effects of potential radiation-induced brain injury.…”

Section: Introductionmentioning

confidence: 99%

Neurocognitive function in patients with head and neck cancer undergoing primary or adjuvant chemoradiation treatment

Bond

Dietrich

Gilbert

et al. 2016

Support Care Cancer

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Purpose Cancer and cancer therapy-related neurocognitive changes negatively affect quality of life, yet few studies have examined neurocognitive changes in patients with head and neck cancer. The purpose of this study was to evaluate neurocognitive performance in patients with head and neck cancer at baseline before starting treatment and 3 months after treatment completion to assess treatment-associated changes in performance. Methods Patients with head and neck cancer who were to receive primary or adjuvant chemoradiation (N = 55) underwent neuropsychological testing before and 3 months posttreatment. Changes in neurocognitive performance were assessed using a practice effect adjusted Reliable Change Index.Results At baseline, 38 % of patients exhibited global neurocognitive impairment. Posttreatment, 21.8 % demonstrated declines in neurocognitive performance in at least one domain. Declines in domain-specific performance ranged from 1.8 to 12.7 % with the greatest decline in language, specifically verb retrieval. Domain-specific improvements ranged from 0 to 7.3 %. Conclusions Patients had a high prevalence of baseline neurocognitive impairment. While neurocognitive performance posttreatment remained unchanged in the majority, almost 13 % suffered declines in language. Small percentages of patients exhibited improvements in their performance. Long-term effects and risk factors for neurocognitive decline in this population should be studied on a larger scale.

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Section: Introductionmentioning

confidence: 99%

Neurocognitive function in patients with head and neck cancer undergoing primary or adjuvant chemoradiation treatment

Bond

Dietrich

Gilbert

et al. 2016

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“…Tang et al [35] reported that NPC patients with radiation-induced brain injury (RI) exhibited negative emotions, impaired cognitive function and quality of life (QOL). The accumulated studies showed that the radiation-induced functional impairments included the disorder of short-term memory [36], personality changes [37] and motor abilities [38], a marked anterograde memory impairment for verbal material [39], neuropsychological impairments in recent memory, immediate and delayed verbal recall, and immediate visual recall [40].…”

Section: Resultsmentioning

confidence: 99%

Identify the radiotherapy-induced abnormal changes in the patients with nasopharyngeal carcinoma

Wang

Zhao

Zhang³

et al. 2017

ADMET DMPK

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<p class="ADMETabstracttext">Radiotherapy (RT) is the standard treatment for nasopharyngeal carcinoma, which often causes inevitable brain injury in the process of treatment. The majority of patients has no abnormal signal or density change of the conventional magnetic resonance imaging (MRI) and computed tomography (CT) examination in the long-term follow-up after radiation therapy. However, when there is a visible CT and conventional MR imaging changes, the damage often has been severe and lack of effective treatments, seriously influencing the prognosis of patients. Therefore, the present study aimed to investigate the abnormal changes in nasopharyngeal carcinoma (NPC) patients after RT. In the present study, we exploited the machine learning framework which contained two parts: feature extraction and classification to automatically detect the brain injury. Our results showed that the method could effectively identify the abnormal regions reduced by radiotherapy. The highest classification accuracy was 82.5 % in the abnormal brain regions. The parahippocampal gyrus was the highest accuracy region, which suggested that the parahippocampal gyrus could be most sensitive to radiotherapy and involved in the pathogenesis of radiotherapy-induced brain injury in NPC patients.</p>

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“…There is still a considerable debate about the effect of radiation on neurocognitive function. Several authors have reported a correlation between cognitive decline and doses to the temporal lobe (42,43,44,45), and these changes are thought to be related to hippocampal damage (46). Gondi et al (47) demonstrated that biologically equivalent doses in 2-Gy fractions (EQD2) delivered to 40% of the bilateral hippocampi (D40%) O7.3 Gy (assuming an a/b ratio of 2 Gy) were associated with long-term impairment in list-learning delayed verbal recall in 18 patients receiving FSRT for benign brain tumors.…”

Section: Discussionmentioning

confidence: 99%

Fractionated stereotactic radiotherapy for large and invasive non-functioning pituitary adenomas: long-term clinical outcomes and volumetric MRI assessment of tumor response

Minniti

Scaringi

Poggi

et al. 2015

European Journal of Endocrinology

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Objective: We describe the use of fractionated stereotactic radiotherapy (FSRT) for the treatment of large, invasive, nonfunctioning pituitary adenomas (NFPAs). FSRT is frequently employed for the treatment of residual or recurrent pituitary adenomas. Patients and methods: Sixty-eight patients with a large residual or recurrent NFPAs were treated between April 2004 and December 2012, including 39 males and 29 females (median age 51 years). Visual defects were present in 34 patients, consisting of visual field defects (nZ31) and/or reduced visual acuity (nZ12). Forty-five patients had evidence of partial or total hypopituitarism before FSRT. For most of the patients, the treatment was delivered through 5-10 noncoplanar conformal fixed fields using a 6-MV linear accelerator to a dose of 45 Gy in 25 fractions. Results: At a median follow-up of 75 months (range 12-120 months), the 5-and 10-year actuarial local control were 97 and 91%, respectively, and overall survival 97 and 93%, respectively. Forty-nine patients had a tumor reduction, 16 remained stable, and three progressed. The relative tumor volume reduction measured using three-dimensional (3D) magnetic resonance imaging (MRI) was 47%. The treatment was well tolerated with minimal acute toxicity. Eighteen patients developed partial or complete hypopituitarism. The actuarial incidence of new anterior pituitary deficits was 40% at 5 years and 72% at 10 years. No other radiation-induced complications occurred. Conclusions: Our results suggest that FSRT is an effective treatment for large or giant pituitary adenomas with low toxicity.

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Cognitive Function Before and After Intensity-Modulated Radiation Therapy in Patients With Nasopharyngeal Carcinoma: A Prospective Study

Cited by 141 publications

References 45 publications

Neurocognitive function in patients with head and neck cancer undergoing primary or adjuvant chemoradiation treatment

Neurocognitive function in patients with head and neck cancer undergoing primary or adjuvant chemoradiation treatment

Identify the radiotherapy-induced abnormal changes in the patients with nasopharyngeal carcinoma

Fractionated stereotactic radiotherapy for large and invasive non-functioning pituitary adenomas: long-term clinical outcomes and volumetric MRI assessment of tumor response

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