Feasibility of neurocognitive outcome evaluations in patients with brain metastases in a multi-institutional cooperative group setting: results of Radiation Therapy Oncology Group trial BR-0018

Regine, W.F.

doi:10.1016/s0360-3016(03)01955-2

Cited by 13 publications

(24 citation statements)

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“…Many authors [2,8,36,45] have used and advocated for other relatively short cognitive screening tests, usually in the form of a battery of several well validated instruments, such as the Hopkins Verbal Learning Test [46], Verbal Fluency/Controlled Word Association Test [47], Trail Making Tests A and B [48], Digit Span [49], Grooved Pegboard [48], and others. Several of these batteries can be completed within 30-40 min, which suggests they would be well tolerated by patients with primary brain tumours [2,8,36].…”

Section: Discussionmentioning

confidence: 99%

Prospective comparison of two cognitive screening tests: diagnostic accuracy and correlation with community integration and quality of life

et al. 2011

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Cognitive screening tests are frequently used in brain tumor clinics. The Mini Mental State Examination (MMSE) is the most commonly used, and the Montreal Cognitive Assessment (MoCA) is an alternative. This study compares the diagnostic accuracy of both screening tests. Fifty-eight patients with brain tumors were prospectively accrued and administered the MMSE and MoCA, 67% of who completed a comprehensive neuropsychological evaluation as a gold standard comparison. Quality of life and community integration were measured with the Functional Assessment of Cancer Therapy-Brain (FACT-Br) and Community Integration Questionnaire (CIQ), respectively. At the pre-defined cut-off scores, the MoCA had superior sensitivity (61.9% vs. 19.0%, P < 0.005) and the MMSE had superior specificity (94.4% vs. 55.6%, P < 0.017). The areas under the ROC curve for the MMSE (0.615, standard error = 0.091) and MoCA (0.606, standard error = 0.092) were poor, indicating that at no single cut-off score is either test both sensitive and specific. Neither the MMSE (ρ = 0.12; P < 0.444) nor MoCA (ρ = 0.24; P < 0.108) were significantly correlated with the FACT-Br. The MoCA was modestly correlated with the CIQ (ρ = 0.35; P < 0.017), but the MMSE was not (ρ = 0.14; P < 0.359). The MMSE has extremely poor sensitivity. Using this test in clinical practice, research, and clinical trials will result in failing to detect cognitive impairment in a substantial percentage of patients. The MoCA has superior sensitivity, and is better correlated with self reported measures of community integration, and therefore should be preferentially chosen in practice and clinical trials.

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Section: Discussionmentioning

confidence: 99%

Prospective comparison of two cognitive screening tests: diagnostic accuracy and correlation with community integration and quality of life

et al. 2011

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“…Regine et al [6] documented the feasibility of incorporating a standardized neurocognitive test battery in multi-institutional trials performed by the Radiation Therapy Oncology Group involving brain metastases patients. Meyers and Brown [7•] emphasized the importance of conducting prospective studies to establish a baseline prior to initiation of treatment, so tumor-related neuropsychological dysfunction can be documented and the effects of various treatment regimens can be ascertained.…”

Section: Assessment Guidelinesmentioning

confidence: 99%

Cognition in brain tumor patients

Correa

2008

Curr Neurol Neurosci Rep

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As effective treatment interventions have increased survival rates, there has been greater awareness that many brain tumor patients experience cognitive dysfunction despite adequate disease control. Cognitive difficulties often have an impact on quality of life and interfere with the patient's ability to function at premorbid levels. A review of the literature indicates that whole-brain radiotherapy alone or in combination with chemotherapy results in more pronounced cognitive dysfunction than either partial radiotherapy or chemotherapy alone. Antiepileptic drugs and corticosteroids may also disrupt cognitive functioning. The cognitive domains suggested to be sensitive to treatment-induced cognitive dysfunction include attention and executive functions, memory, and psychomotor speed. Recent studies have proposed guidelines for the neuropsychological assessment of brain tumor patients and emphasized the importance of including sensitive measures in future clinical trials. This approach will increase our understanding of the incidence of cognitive dysfunction in this population and provide relevant information about therapy-related neurotoxicity.

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“…The shortened version consists of 32 items measuring 5 dimensions (depression, anger, fatigue, vigor and tension). The POMS is frequently used in physiological studies and pharmacological studies to study and control for changes in mood during the experimentation session and is also used in neurocognitive outcome studies in cancer patients [2,30]. The POMS was administered at the beginning and at the end of the experimentation session.…”

Section: Psychological Distressmentioning

confidence: 99%

Electrophysiological Correlates of Information Processing in Breast-Cancer Patients Treated With Adjuvant Chemotherapy

Kreukels

Schagen

Ridderinkhof

et al. 2005

Breast Cancer Res Treat

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Cognitive deficits are found in a number of breast-cancer patients who have undergone adjuvant (Cyclophosphamide, Methotrexate, and 5-Fluorouracil (CMF)) chemotherapy, but the underlying mechanisms are still unclear. The objective of this study is to investigate information processing in these patients with concurrent registration of brain activity. Twenty-six breast-cancer patients treated with adjuvant CMF chemotherapy and a control group of 23 stage I breast-cancer patients not treated with chemotherapy were examined. Mean time since treatment for the CMF patients was 5.1 years after the last CMF course, and for the control patients 3.6 years after termination of radiotherapy. An information processing task was administered with concurrent EEG registration. Reaction times and the amplitudes and latencies of an Event Related Potential component (P3) in different task conditions related to input, central, and output processing of information were studied. Significant differences in latency and amplitude of the P3 component were found between the treatment groups with an earlier and reduced P3 in the chemotherapy group. Patients treated with chemotherapy had longer reaction times (although not significantly different) than the control group on all task conditions. Our data provide further evidence for long-term neurocognitive problems in breast-cancer patients treated with adjuvant (CMF) chemotherapy and offer new information regarding abnormalities in brain functioning in these patients.

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Feasibility of neurocognitive outcome evaluations in patients with brain metastases in a multi-institutional cooperative group setting: results of Radiation Therapy Oncology Group trial BR-0018

Cited by 13 publications

References 0 publications

Prospective comparison of two cognitive screening tests: diagnostic accuracy and correlation with community integration and quality of life

Prospective comparison of two cognitive screening tests: diagnostic accuracy and correlation with community integration and quality of life

Cognition in brain tumor patients

Electrophysiological Correlates of Information Processing in Breast-Cancer Patients Treated With Adjuvant Chemotherapy

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