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Rydelius A, Lätt J, Kinhult S, Engelholm S, Van Westen D, Pihlsgård M, Bengzon J, Sundgren PC, Lilja Å. Longitudinal study of cognitive function in glioma patients treated with modern radiotherapy techniques and standard chemotherapy. Acta Oncol 2020; 59:1091-1097. [PMID: 32847475 DOI: 10.1080/0284186x.2020.1778181] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction: Cognitive function is an important outcome measure in patients with brain tumor, providing information about the patient's clinical situation, treatment effects and possible progressive disease. The aim of this longitudinal study was to evaluate effects of the currently used radiation and chemotherapy treatment on cognitive function and to investigate associations between cognitive function at baseline and progression as well as overall survival.Methods: 32 patients newly diagnosed with malignant glioma were evaluated at baseline with CNS Vital Signs (CNS-VS), a computerized standardized neuropsychological test battery, prior to arc-based radiotherapy and concomitant chemotherapy with Temozolomide. CNS-VS measures the cognitive functions known to be affected in patients with brain tumor, covering nine cognitive domains. Follow-up cognitive evaluations were performed in 26 patients after 3.5 months and in 13 patients 1 year after treatment start.Results: Overall cognitive scores were lower in the studied patient cohort at baseline compared to standardized domain scores. At 3.5 months follow-up cognitive functioning was slightly decreased, but only in 1/9 cognitive domains - visual memory - where significant changes were found compared to baseline test results. Similarly, at 12 months follow-up no significant changes in cognitive test results were seen compared to baseline examination, except for a decrease in the visual memory domain. In relation to early progression, the most significant cognitive deficits were dysfunctional visual memory and low executive functioning at baseline. Low executive function at baseline correlated most significantly with shorter overall survival.Conclusion: The present study suggests that the currently used arc-based radiotherapy and chemotherapy might affect cognitive function less negatively than previously described during treatment and in the first year after treatment in malignant glioma patients. In general, a high cognitive test score at baseline was associated with longer time to progression and with longer survival.
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Affiliation(s)
- Anna Rydelius
- Department of Clinical Sciences, Division of Neurology, Lund University, Lund, Sweden
| | - Jimmy Lätt
- Department of Medical Imaging and Physiology, Skåne University hospital Lund University, Lund, Sweden
| | - Sara Kinhult
- Department of Clinical Sciences, Division of Oncology, Lund University, Lund, Sweden
| | - Silke Engelholm
- Department of Clinical Sciences, Division of Oncology, Lund University, Lund, Sweden
| | - Danielle Van Westen
- Department of Medical Imaging and Physiology, Skåne University hospital Lund University, Lund, Sweden
- Department of Clinical Sciences, Division of Radiology, Lund University, Lund, Sweden
| | - Mats Pihlsgård
- Department of Clinical Sciences, Division of Geriatrics, Lund University, Malmö, Sweden
| | - Johan Bengzon
- Department of Clinical Sciences, Division of Neurosurgery, Lund University, Lund, Sweden
- Stem Cell Center, BMC B10, Lund University, Lund, Sweden
| | - Pia C. Sundgren
- Department of Medical Imaging and Physiology, Skåne University hospital Lund University, Lund, Sweden
- Department of Clinical Sciences, Division of Radiology, Lund University, Lund, Sweden
- Lund University BioImaging Center, Lund University, Lund, Sweden
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Åsa Lilja
- Department of Clinical Sciences, Division of Radiology, Lund University, Lund, Sweden
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