A prospective study of effects of whole brain radiotherapy on cognitive function and quality of life in patients with brain metastases from lung cancer
Lian Yixin,Zhou Mengyun,Zou Li,Chen Qingqing,Tian Ye
Department of Respiration (Lian YX),Department of Radiotherapy and Oncology (Zhou MY,Zou L,Chen QQ, Tian Y),Second Affiliated Hospital of Soochow University,Suzhou 215004,China
Abstract： Objective To evaluate the effects of whole brain radiotherapy (WBRT) on cognitive function and quality of life (QOL) in patients with brain metastases from lung cancer. Methods A total of 41 patients with brain metastases from lung cancer who were admitted to our hospital and treated with WBRT in 2015 were enrolled as subjects. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used for cognitive evaluation. The Alzheimer′s Disease Cooperative Study Activity of Daily Living (ADCS-ADL) scale was used for evaluation of QOL. Comparison of cognitive function and QOL before and after WBRT was made by the independent sample t-test. Results The incidence rates of cognitive dysfunction based on MoCA and MMSE were 96.55% and 48.28% before WBRT, and 94.29% and 31.43% after WBRT, respectively. There were no significant changes in MoCA score, MMSE score, or ADCS-ADL score after WBRT (18.24±0.95 vs. 19.37±0.70,P=0.341;23.51±0.88 vs. 24.54±0.71,P=0.375;57.44±2.59 vs. 59.37±2.27,P=0.583). Conclusions WBRT has no significant impacts on cognitive function and QOL in patients with brain metastases from lung cancer. MoCA is more sensitive than MMSE in detection of cognitive dysfunction in patients with brain metastases.
Lian Yixin,Zhou Mengyun,Zou Li et al. A prospective study of effects of whole brain radiotherapy on cognitive function and quality of life in patients with brain metastases from lung cancer[J]. Chinese Journal of Radiation Oncology, 2016, 25(12): 1290-1294.
[1] Villano JL,Durbin EB,Normandeau C,et al. Incidence of brain metastasis at initial presentation of lung cancer[J].Neuro Oncol,2015,17:122-128.10.1093/neuonc/nou099. [2] Arrieta O,Villarreal-Garza C,Zamora J,et al. Long-term survival in patients with non-small cell lung cancer and synchronous brain metastasis treated with whole-brain radiotherapy and thoracic chemoradiation[J].Radiat Oncol,2011,6:166.10.1186/1748-717X-6-166. [3] Mekhail T,Sombeck M,Sollaccio R.Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases:results of the EORTC 22952-26001 study[J].Curr Oncol Rep,2011,13(4):255-258.10.1007/s11912-011-0180-1. [4] Sundaresan P,Yeghiaian-Alvandi R,Gebski V.Prognostic index to identify patients who may not benefit from whole brain radiotherapy for multiple brain metastases from lung cancer[J].J Med Imaging Radiat Oncol,2010,54(1):69-75. [5] Sneed PK,Suh JH,Goetsch SJ,et al. A multi-institutional review of radiosurgery alone vs.radiosurgery with whole brain radiotherapy as the initial management of brain metastases[J].Int J Radiat Oncol Biol Phys,2002,53(3):519-526. [6] 温洪波,张振馨,牛富生,等.北京地区蒙特利尔认知量表的应用研究[J].中华内科杂志,2008,47(1):36-39.10.3321/j.issn.0578-1426.2008.01.012. Wen HB, Zhang ZX,Niu FS,et al. The applicaton of montreal cognitive assessment in urban chinese residents of beijing[J].Chin J Int Med, 2008,47(1):36-39.10.3321/j.issn.0578-1426.2008.01.012. [7] 张振馨,洪霞,李辉,等.北京城乡 55岁或以上居民简易智能状态检查测试结果的分布特征[J].中华神经科杂志,1999,32(3):149-153.10.3760/j.issn.1006-7876.1999.03.006. Zhang ZX,Hong X,Li H,et al. The mini-mental state examination in the Chinese residents population aged 55 years and over in the urban and rural areas of Beijing[J].Chin J Neurol, 1999,32(3):149-153.10.3760/j.issn.1006-7876.1999.03.006. [8] National comprehensive cancer network. NCCN clinical practice guidelines in oncology:central nervous system cancers (Version 1.2015)[R/OL].2015[2016-04-10].https://www.nccn.org/. [9] Patil CG,Pricola K,Sarmiento JM,et al. Whole brain radiation therapy (WBRT) alone versus WBRT and radiosurgery for the treatment of brain metastases[J].Cochrane Database Syst Rev,2012,9:CD006121.10.1002/14651858.CD006121.pub2. [10] Meyers CA,Smith JA,Bezjak A,et al. Neurocognitive function and progression in patients with brain metastases treated with whole-brain radiation and motexafin gadolinium:results of a randomized phase Ⅲ trial[J].J Clin Oncol,2004,22(1):157-165. [11] Tallet AV,Azria D,Barlesi F,et al. Neurocognitive function impairment after whole brain radiotherapy for brain metastases:actual assessment[J].Radiat Oncol,2012,7:77.10.1186/1748-717X-7-77. [12] Pinkham MB,Sanghera P,Wall GK,et al. Neurocognitive Effects Following Cranial Irradiation for Brain Metastases[J].Clin Oncol (R Coll Radiol),2015,27(11):630-639.10.1016/j.clon.2015.06.005. [13] Szerlip N,Rutter C,Ram N,et al. Factors impacting volumetric white matter changes following whole brain radiation therapy[J].J Neurooncol,2011,103(1):111-119.10.1007/s11060-010-0358-7. [14] 郭旗,田野.放疗对低级别脑胶质瘤患者认知功能的影响及防治方法[J].中华放射医学与防护杂志,2015,35(5):397-400.10.3760/cma.j.issn.0254-5098.2015.05.021. Guo Q, Tian Y.Effect of radiotherapy on cognitive function in patients with low grade gliomas and its prevention and treatment[J].Chin J Radiol Med Prot, 2015,35(5):397-400.10.3760/cma.j.issn.0254-5098.2015.05.021. [15] Preusser M,Winkler F,Collette L,et al. Trial design on prophylaxis and treatment of brain metastases:lessons learned from the EORTC Brain Metastases Strategic Meeting 2012[J].Eur J Cancer,2012,48(18):3439-3447.10.1016/j.ejca.2012.07.002. [16] Lin NU,Wefel JS,Lee EQ,et al. Challenges relating to solid tumour brain metastases in clinical trials,part 2:neurocognitive,neurological,and quality-of-life outcomes. A report from the RANO group[J].Lancet Oncol,2013,14(10):e407-416.10.1016/S1470-2045(13)70308-5. [17] Nakazaki K,Kano H.Evaluation of mini-mental status examination score after gamma knife radiosurgery as the first radiation treatment for brain metastases[J].J Neurooncol,2013,112(3):421-425.10.1007/s11060-013-1071-0. [18] Minniti G,Esposito V,Clarke E,et al. Stereotactic radiosurgery in elderly patients with brain metastases[J].J Neurooncol,2013,111(3):319-325.10.1007/s11060-012-1016-z. [19] Nasreddine ZS,Phillips NA,Bedirian V,et al. The Montreal Cognitive Assessment,MoCA:a brief screening tool for mild cognitive impairment[J].J Am Geriatr Soc,2005,53(4):695-699. [20] Olson RA,Chhanabhai T,McKenzie M.Feasibility study of the Montreal Cognitive Assessment (MoCA) in patients with brain metastases[J].Support Care Cancer,2008,16(11):1273-1278.10.1007/s00520-008-0431-3. [21] Addeo R,Caraglia M,Faiola V,et al. Concomitant treatment of brain metastasis with whole brain radiotherapy[WBRT] and temozolomide[TMZ] is active and improves quality of life[J].BMC Cancer,2007,7:18.10.1186/1471-2407-7-18. [22] Li J,Bentzen SM,Li J,et al. Relationship between neurocognitive function and quality of life after whole-brain radiotherapy in patients with brain metastasis[J].Int J Radiat Oncol Biol Phys,2008,71(1):64-70.10.1016/j.nimb.2006.04.083.
2016, Vol. 25 
