Quality of Life and Cognitive Function Evaluations and Interventions for Patients with Brain Metastases in the Radiation Oncology Clinic

Matsui, Jennifer K.; Perlow, Haley K.; Baiyee, Cyril; Ritter, Alex R.; Mishra, Mark V.; Bovi, Joseph; Gondi, Vinai; Brown, Paul D.; Loughan, Ashlee R.; Leeper, Heather; Dawson, Erica L.; Palmer, Joshua D.

doi:10.3390/cancers14174301

Cited by 7 publications

(4 citation statements)

References 151 publications

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“…Besides, this is to limit confounding factors underlying the acute and early delayed injury likely due to edema with an increase in nerve cell or stromal size [ 61 ]. Notably, during the late-delayed phase, patients tend to experience deficits in memory, spatial relations, visual motor processing, quantitative skills and attention, including somnolence syndromes [ 48 , 62 ]. Interestingly, in the present study, a negative correlation was observed between the neurocognitive tests and QoL.…”

Section: Discussionmentioning

confidence: 99%

Remote assessment of cognition and quality of life following radiotherapy for nasopharyngeal carcinoma: deep-learning-based predictive models and MRI correlates

2023

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Purpose Irradiation of the brain regions from nasopharyngeal carcinoma (NPC) radiotherapy (RT) is frequently unavoidable, which may result in radiation-induced cognitive deficit. Using deep learning (DL), the study aims to develop prediction models in predicting compromised cognition in patients following NPC RT using remote assessments and determine their relation to the quality of life (QoL) and MRI changes. Methods Seventy patients (20–76 aged) with MRI imaging (pre- and post-RT (6 months–1 year)) and complete cognitive assessments were recruited. Hippocampus, temporal lobes (TLs), and cerebellum were delineated and dosimetry parameters were extracted. Assessments were given post-RT via telephone (Telephone Interview Cognitive Status (TICS), Telephone Montreal Cognitive Assessment (T-MoCA), Telephone Mini Addenbrooke’s Cognitive Examination (Tele-MACE), and QLQ-H&N 43). Regression and deep neural network (DNN) models were used to predict post-RT cognition using anatomical and treatment dose features. Results Remote cognitive assessments were inter-correlated ( r > 0.9). TLs showed significance in pre- and post-RT volume differences and cognitive deficits, that are correlated with RT-associated volume atrophy and dose distribution. Good classification accuracy based on DNN area under receiver operating curve (AUROC) for cognitive prediction (T-MoCA AUROC = 0.878, TICS AUROC = 0.89, Tele-MACE AUROC = 0.919). Conclusion DL-based prediction models assessed using remote assessments can assist in predicting cognitive deficit following NPC RT. Comparable results of remote assessments in assessing cognition suggest its possibility in replacing standard assessments. Implications for Cancer Survivors Application of prediction models in individual patient enables tailored interventions to be provided in managing cognitive changes following NPC RT. Supplementary information The online version contains supplementary material available at 10.1007/s11764-023-01371-8.

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Section: Discussionmentioning

confidence: 99%

Remote assessment of cognition and quality of life following radiotherapy for nasopharyngeal carcinoma: deep-learning-based predictive models and MRI correlates

2023

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“…The two-year survival rate for patients with BM is typically less than 10% 12 . RT, including WBRT and SRS, is one of the essential treatments for BM.…”

Section: Future and Prospectsmentioning

confidence: 99%

“…Common primary tumors associated with BM include lung cancer [5][6][7] , breast cancer [4,8,9] , and malignant melanoma [10,11] . Despite multiple interventions, such as surgery, radiotherapy (RT), and chemotherapy, patients with brain metastases face disappointingly short survival, with a 2-year survival rate that is less than 10% [12] . In recent years, the application of targeted therapy and immunotherapy has led to improvements in survival [4,12,13] .…”

Section: Introductionmentioning

confidence: 99%

Radiotherapy in Preclinical Models of Brain Metastases: A Review and Recommendations for Future Studies

Shi,

Tanzhu,

Chen

et al. 2024

Int. J. Biol. Sci.

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Brain metastases (BMs) frequently occur in primary tumors such as lung cancer, breast cancer, and melanoma, and are associated with notably short natural survival. In addition to surgical interventions, chemotherapy, targeted therapy, and immunotherapy, radiotherapy (RT) is a crucial treatment for BM and encompasses whole-brain radiotherapy (WBRT) and stereotactic radiosurgery (SRS). Validating the efficacy and safety of treatment regimens through preclinical models is imperative for successful translation to clinical application. This not only advances fundamental research but also forms the theoretical foundation for clinical study. This review, grounded in animal models of brain metastases (AM-BM), explores the theoretical underpinnings and practical applications of radiotherapy in combination with chemotherapy, targeted therapy, immunotherapy, and emerging technologies such as nanomaterials and oxygen-containing microbubbles. Initially, we provided a concise overview of the establishment of AM-BMs. Subsequently, we summarize key RT parameters (RT mode, dose, fraction, dose rate) and their corresponding effects in AM-BMs. Finally, we present a comprehensive analysis of the current research status and future directions for combination therapy based on RT. In summary, there is presently no standardized regimen for AM-BM treatment involving RT. Further research is essential to deepen our understanding of the relationships between various parameters and their respective effects.

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“…Metastatic brain tumors occur in approximately 20% of patients with malignant tumors [ 1 ]. The existence of brain metastases often indicates poor quality of life and survival with a 2 year survival rate of patients with brain metastases less than 10% in general [ 2 ]. The evolving anti-tumor systemic management has improved the survival of patients to a certain degree [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Optimal timing and sequence of combining stereotactic radiosurgery with immune checkpoint inhibitors in treating brain metastases: clinical evidence and mechanistic basis

et al. 2023

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Recent evidence has shown that immune checkpoint inhibitors (ICIs) are efficacious for treating brain metastases of various primary tumors. However, the immunosuppressive tumor microenvironment and the blood–brain barrier (BBB) or blood-tumor barrier (BTB) essentially restrict the efficacy of ICIs. Stereotactic radiosurgery (SRS) can be a powerful ally to ICIs due to its trait of disrupting the BBB/BTB and increasing the immunogenicity of brain metastases. The combination of SRS + ICI has shown synergy in brain metastases in several retrospective studies. Nevertheless, the optimal schedule for the combination of SRS and ICI in brain metastases is yet to be determined. In this review, we summarized the current clinical and preclinical evidence on the timing and sequence of SRS + ICI to provide insight into the current state of knowledge about this important area in patient care.

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Quality of Life and Cognitive Function Evaluations and Interventions for Patients with Brain Metastases in the Radiation Oncology Clinic

Cited by 7 publications

References 151 publications

Remote assessment of cognition and quality of life following radiotherapy for nasopharyngeal carcinoma: deep-learning-based predictive models and MRI correlates

Remote assessment of cognition and quality of life following radiotherapy for nasopharyngeal carcinoma: deep-learning-based predictive models and MRI correlates

Radiotherapy in Preclinical Models of Brain Metastases: A Review and Recommendations for Future Studies

Optimal timing and sequence of combining stereotactic radiosurgery with immune checkpoint inhibitors in treating brain metastases: clinical evidence and mechanistic basis

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