Long-term neurocognitive function and quality of life after multimodal therapy in adult glioma patients: a prospective long-term follow-up

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Milena Pertz - , Ruhr-Universität Bochum (Autor:in)
  • Sabine Schlömer - , Ruhr-Universität Bochum (Autor:in)
  • Clemens Seidel - , Universität Leipzig (Autor:in)
  • Bettina Hentschel - , Universität Leipzig (Autor:in)
  • Markus Löffler - , Universität Leipzig (Autor:in)
  • Gabriele Schackert - , Technische Universität Dresden (Autor:in)
  • Dietmar Krex - , Klinik und Poliklinik für Neurochirurgie, Technische Universität Dresden (Autor:in)
  • Tareq Juratli - , Klinik und Poliklinik für Neurochirurgie, Technische Universität Dresden (Autor:in)
  • Joerg Christian Tonn - , Ludwig-Maximilians-Universität München (LMU) (Autor:in)
  • Oliver Schnell - , Ludwig-Maximilians-Universität München (LMU), Albert-Ludwigs-Universität Freiburg (Autor:in)
  • Hartmut Vatter - , Universität Bonn (Autor:in)
  • Matthias Simon - , Universität Bonn, Universitätsklinikum Ostwestfalen-Lippe (OWL) (Autor:in)
  • Manfred Westphal - , Universität Hamburg (Autor:in)
  • Tobias Martens - , Universität Hamburg, Asklepios Klinik St. Georg (Autor:in)
  • Michael Sabel - , Heinrich Heine Universität Düsseldorf (Autor:in)
  • Martin Bendszus - , Universität Heidelberg (Autor:in)
  • Nils Dörner - , Universität Heidelberg, Universität Duisburg-Essen (Autor:in)
  • Antje Wick - , Universität Heidelberg, Deutsches Krebsforschungszentrum (DKFZ) (Autor:in)
  • Klaus Fliessbach - , Universität Bonn (Autor:in)
  • Christian Hoppe - , Universität Bonn (Autor:in)
  • Marcel Klingner - , Universität Leipzig (Autor:in)
  • Jörg Felsberg - , Heinrich Heine Universität Düsseldorf (Autor:in)
  • Guido Reifenberger - , Heinrich Heine Universität Düsseldorf (Autor:in)
  • Dorothee Gramatzki - , Universität Zürich (Autor:in)
  • Michael Weller - , Universität Zürich, Eberhard Karls Universität Tübingen (Autor:in)
  • Uwe Schlegel - , Ruhr-Universität Bochum, Klinik Hirslanden (Autor:in)

Abstract

Purpose: Multimodal therapies have significantly improved prognosis in glioma. However, in particular radiotherapy may induce long-term neurotoxicity compromising patients’ neurocognition and quality of life. The present prospective multicenter study aimed to evaluate associations of multimodal treatment with neurocognition with a particular focus on hippocampal irradiation. Methods: Seventy-one glioma patients (WHO grade 1–4) were serially evaluated with neurocognitive testing and quality of life questionnaires. Prior to (baseline) and following further treatment (median 7.1 years [range 4.6–11.0] after baseline) a standardized computerized neurocognitive test battery (NeuroCog FX) was applied to gauge psychomotor speed and inhibition, verbal short-term memory, working memory, verbal and non-verbal memory as well as verbal fluency. Mean ipsilateral hippocampal radiation dose was determined in a subgroup of 27 patients who received radiotherapy according to radiotherapy plans to evaluate its association with neurocognition. Results: Between baseline and follow-up mean performance in none of the cognitive domains significantly declined in any treatment modality (radiotherapy, chemotherapy, combined radio-chemotherapy, watchful-waiting), except for selective attention in patients receiving chemotherapy alone. Apart from one subtest (inhibition), mean ipsilateral hippocampal radiation dose > 50 Gy (Dmean) as compared to < 10 Gy showed no associations with long-term cognitive functioning. However, patients with Dmean < 10 Gy showed stable or improved performance in all cognitive domains, while patients with > 50 Gy numerically deteriorated in 4/8 domains. Conclusions: Multimodal glioma therapy seems to affect neurocognition less than generally assumed. Even patients with unilateral hippocampal irradiation with > 50 Gy showed no profound cognitive decline in this series.

Details

OriginalspracheEnglisch
Seiten (von - bis)353-366
Seitenumfang14
FachzeitschriftJournal of neuro-oncology
Jahrgang164
Ausgabenummer2
PublikationsstatusVeröffentlicht - Sept. 2023
Peer-Review-StatusJa

Externe IDs

PubMed 37648934

Schlagworte

Ziele für nachhaltige Entwicklung

Schlagwörter

  • Glioma, Multimodal tumor-directed treatment, Neurocognition, Quality of life, Radiotherapy, Prospective Studies, Follow-Up Studies, Humans, Combined Modality Therapy, Glioma/complications, Brain Neoplasms/complications, Quality of Life, Adult