| Abstract: |
Although few studies have examined cognitive outcome in adult brain tumor patients, a review of the literature suggests that tumor and the delayed effects of treatment contribute to cognitive dysfunction in a significant number of patients. The specific contribution of tumor is difficult to determine, because several studies were retrospective and assessed cognitive performance subsequent to treatment. The studies reviewed showed that whole-brain RT alone or in combination with HD-chemotherapy resulted in more pronounced cognitive dysfunction than partial RT or HD-chemotherapy alone. Cognitive domains that are particularly sensitive to the delayed effects of treatment include attention, executive functions, memory, and psychomotor speed. Collaborative efforts are required to include cognitive outcome measures in prospective clinical trials in neuro-oncology. Increased understanding of the incidence of cognitive dysfunction in brain tumor patients is likely to provide relevant information about the neurotoxicity associated with various treatment regimens. This knowledge would enable physicians and patients to make decisions regarding treatment based not only on survival rates and time to disease progression but also on QOL. Continued efforts are also necessary to identify possible contributing factors for the development of treatment-related cognitive dysfunction (eg, genetic susceptibility) and to assess the efficacy of pharmacologic and behavioral interventions to improve cognitive function in brain tumor patients. © 2006 Elsevier Inc. All rights reserved. |
