Cognitive functions in survivors of primary central nervous system lymphoma Journal Article
| Authors: | Correa, D. D.; Deangelis, L. M.; Shi, W.; Thaler, H.; Glass, A.; Abrey, L. E. |
| Article Title: | Cognitive functions in survivors of primary central nervous system lymphoma |
| Abstract: | Background: The standard treatment for primary CNS lymphoma (PCNSL) involves high-dose methotrexate-based (MTX) chemotherapy and whole brain radiotherapy (WBRT). This combined regimen prolongs patient survival, but also carries a substantial risk for delayed neurotoxicity particularly in the elderly. However, cognitive outcome evaluations have not been included in most clinical trials. Objective: To assess cognitive functioning and quality of life in PCNSL survivors treated either with WBRT ± MTX-based chemotherapy or chemotherapy alone. Methods: Twenty-eight PCNSL patients in disease remission received a post-treatment baseline neuropsychological evaluation, and a subset of patients were available for an 8-month follow-up evaluation. Assessment of quality of life and extent of white matter disease on MRI were also performed. Results: Patients displayed mild to moderate impairments across several cognitive domains. These were of sufficient severity to reduce quality of life in half of the patient sample. Comparisons according to treatment type revealed more pronounced cognitive impairment, particularly in the memory and attention/executive domains, among patients treated with WBRT ± chemotherapy. Extent of white matter disease correlated with attention/executive, memory, and language impairment. Conclusions: PCNSL survivors treated with WBRT ± chemotherapy displayed more pronounced cognitive dysfunction than patients treated with MTX-based chemotherapy alone. |
| Keywords: | adult; clinical article; aged; aged, 80 and over; middle aged; cancer radiotherapy; combined modality therapy; cytarabine; methotrexate; brain radiation; magnetic resonance imaging; prospective studies; quality of life; cohort studies; antineoplastic combined chemotherapy protocols; atrophy; vincristine; risk factor; lomustine; procarbazine; central nervous system tumor; cranial irradiation; risk assessment; central nervous system neoplasms; survivors; brain; lymphoma, non-hodgkin; lymphoma; neuropsychological tests; remission induction; cognitive defect; cognition disorders; memory; attention; injections, spinal; language ability; myelin sheath; humans; human; male; female; priority journal; article |
| Journal Title: | Neurology |
| Volume: | 62 |
| Issue: | 4 |
| ISSN: | 0028-3878 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2004-02-24 |
| Start Page: | 548 |
| End Page: | 555 |
| Language: | English |
| PROVIDER: | scopus |
| PUBMED: | 14981169 |
| DOI/URL: | |
| Notes: | Neurology -- Cited By (since 1996):107 -- Export Date: 16 June 2014 -- CODEN: NEURA C2 - 14981169 -- Source: Scopus |
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