Prospective cognitive follow-up in primary CNS lymphoma patients treated with chemotherapy and reduced-dose radiotherapy Journal Article
| Authors: | Correa, D. D.; Rocco-Donovan, M.; Deangelis, L. M.; Dolgoff-Kaspar, R.; Iwamoto, F.; Yahalom, J.; Abrey, L. E. |
| Article Title: | Prospective cognitive follow-up in primary CNS lymphoma patients treated with chemotherapy and reduced-dose radiotherapy |
| Abstract: | High-dose chemotherapy and whole brain radiotherapy (WBRT) can prolong survival in primary CNS lymphoma (PCNSL) patients, but is often associated with clinically significant cognitive decline. In this study we assessed neuropsychological functioning prospectively in newly diagnosed PCNSL patients treated with induction chemotherapy followed by reduced-dose WBRT. Twelve patients underwent neuropsychological evaluations at diagnosis, after induction chemotherapy, and 6 and 12 months after WBRT. Nine patients completed additional cognitive evaluations 18 and 24 months post-treatment. At diagnosis, patients had impairments in Executive Functions, Verbal Memory, and Motor Speed. There was a significant improvement in Executive Functions (P < 0.01) and Verbal Memory (P < 0.05) following induction chemotherapy, and scores remained relatively stable up to 12 months post-treatment. Among the nine patients who completed a 2-year follow-up, there was a significant improvement in the Executive domain (P < 0.05) and a trend toward a decline in the Verbal Memory domain. Executive and Verbal Memory functions improved following induction chemotherapy, likely due to decreased tumor burden and discontinuation of corticosteroid and anticonvulsant medications. There was no significant cognitive decline up to 24 months post-chemotherapy and reduced-dose WBRT in this group of PCNSL patients, however, difficulties in Verbal Memory and Motor speed persisted over the follow-up period. © Springer Science+Business Media, LLC. 2008. |
| Keywords: | adult; cancer chemotherapy; clinical article; controlled study; treatment response; aged; middle aged; clinical trial; dose response; drug dose reduction; drug withdrawal; cancer radiotherapy; radiation dose; chemotherapy; primary central nervous system lymphoma; cytarabine; methotrexate; rituximab; drug megadose; outcome assessment; follow up; follow-up studies; magnetic resonance imaging; prospective studies; controlled clinical trial; multiple cycle treatment; tumor volume; radiotherapy; vincristine; procarbazine; time factors; central nervous system neoplasms; whole body radiation; lymphoma; neuropsychological test; neuropsychological tests; mental disease; cognitive defect; problem solving; seizure; cognitive; neuropsychological assessment; primary cns lymphoma; anticonvulsive agent; corticosteroid; memory disorder; mental deterioration; mental function; motor dysfunction; motor performance; verbal memory; cognition disorders; drug therapy; memory; motor activity; verbal learning |
| Journal Title: | Journal of Neuro-Oncology |
| Volume: | 91 |
| Issue: | 3 |
| ISSN: | 0167-594X |
| Publisher: | Springer |
| Date Published: | 2009-02-01 |
| Start Page: | 315 |
| End Page: | 321 |
| Language: | English |
| DOI: | 10.1007/s11060-008-9716-0 |
| PUBMED: | 18974934 |
| PROVIDER: | scopus |
| PMCID: | PMC7213759 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 9" - "Export Date: 30 November 2010" - "CODEN: JNODD" - "Source: Scopus" |
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