Mid-term treatment-related cognitive sequelae in glioma patients

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Sabine Schlömer - , Ruhr-Universität Bochum (Autor:in)
  • Jörg Felsberg - , Heinrich Heine Universität Düsseldorf (Autor:in)
  • Milena Pertz - , Ruhr-Universität Bochum (Autor:in)
  • Bettina Hentschel - , Universität Leipzig (Autor:in)
  • Markus Löffler - , Universität Leipzig (Autor:in)
  • Gabriele Schackert - , Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Dietmar Krex - , Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Tareq Juratli - , Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus 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 - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)
  • Tobias Martens - , Universitätsklinikum Hamburg-Eppendorf (UKE), 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)
  • Klaus Fliessbach - , Universität Bonn (Autor:in)
  • Christian Hoppe - , Universität Bonn (Autor:in)
  • Guido Reifenberger - , Heinrich Heine Universität Düsseldorf (Autor:in)
  • Michael Weller - , Universität Zürich, Eberhard Karls Universität Tübingen (Autor:in)
  • Uwe Schlegel - , Ruhr-Universität Bochum (Autor:in)
  • for the German Glioma Network - (Autor:in)

Abstract

Purpose: Cognitive functioning represents an essential determinant of quality of life. Since significant advances in neuro-oncological treatment have led to prolonged survival it is important to reliably identify possible treatment-related neurocognitive dysfunction in brain tumor patients. Therefore, the present study specifically evaluates the effects of standard treatment modalities on neurocognitive functions in glioma patients within two years after surgery. Methods: Eighty-six patients with World Health Organization (WHO) grade 1–4 gliomas were treated between 2004 and 2012 and prospectively followed within the German Glioma Network. They received serial neuropsychological assessment of attention, memory and executive functions using the computer-based test battery NeuroCog FX. As the primary outcome the extent of change in cognitive performance over time was compared between patients who received radiotherapy, chemotherapy or combined radio-chemotherapy and patients without any adjuvant therapy. Additionally, the effect of irradiation and chemotherapy was assessed in subgroup analyses. Furthermore, the potential impact of the extent of tumor resection and histopathological characteristics on cognitive functioning were referred to as secondary outcomes. Results: After a median of 16.8 (range 5.9–31.1) months between post-surgery baseline neuropsychological assessment and follow-up assessment, all treatment groups showed numerical and often even statistically significant improvement in all cognitive domains. The extent of change in cognitive functioning showed no difference between treatment groups. Concerning figural memory only, irradiated patients showed less improvement than non-irradiated patients (p = 0.029, η2 = 0.06). Resected patients, yet not patients with biopsy, showed improvement in all cognitive domains. Compared to patients with astrocytomas, patients with oligodendrogliomas revealed a greater potential to improve in attentional and executive functions. However, the heterogeneity of the patient group and the potentially selected cohort may confound results. Conclusion: Within a two-year post-surgery interval, radiotherapy, chemotherapy or their combination as standard treatment did not have a detrimental effect on cognitive functions in WHO grade 1–4 glioma patients. Cognitive performance in patients with adjuvant treatment was comparable to that of patients without.

Details

OriginalspracheEnglisch
Seiten (von - bis)65-79
Seitenumfang15
FachzeitschriftJournal of neuro-oncology
Jahrgang159
Ausgabenummer1
PublikationsstatusVeröffentlicht - Aug. 2022
Peer-Review-StatusJa

Externe IDs

PubMed 35796933

Schlagworte

Ziele für nachhaltige Entwicklung

Schlagwörter

  • Glioma, NeuroCog FX, Neuropsychological assessment, Prospective, Treatment-related neurotoxicity