Self-reported cognitive outcomes in patients with brain metastases before and after radiation therapy.

Abstract

PURPOSE:

Patients with brain metastases may experience treatment-related cognitive deficits. In this study, we prospectively assessed the self-reported cognitive abilities of patients with brain metastases from any solid primary cancer before and after irradiation of the brain.

METHODS AND MATERIALS:

The treatment group (TG) consisted of adult patients (n=50) with brain metastases who received whole or partial irradiation of the brain without having received prior radiation therapy (RT). The control group (CG) consisted of breast cancer patients (n=27) without cranial involvement who were treated with adjuvant RT. Patients were recruited between May 2008 and December 2010. Self-reported cognitive abilities were acquired before RT and 6 weeks, 3 months, and 6 months after irradiation. The information regarding the neurocognitive status was collected by use of the German questionnaires for self-perceived deficits in attention (FEDA) and subjectively experienced everyday memory performance (FEAG).

RESULTS:

The baseline data showed a high proportion of self-perceived neurocognitive deficits in both groups. A comparison between the TG and the CG regarding the course of self-reported outcomes after RT showed significant between-group differences for the FEDA scales 2 and 3: fatigue and retardation of daily living activities (P=.002) and decrease in motivation (P=.032) with an increase of attention deficits in the TG, but not in the CG. There was a trend towards significance in FEDA scale 1: distractibility and retardation of mental processes (P=.059) between the TG and the CG. The FEAG assessment presented no significant differences. An additional subgroup analysis within the TG was carried out. FEDA scale 3 showed significant differences in the time-related progress between patients with whole-brain RT and those receiving hypofractionated stereotactic RT (P=.025), with less decrease in motivation in the latter group.

CONCLUSION:

Self-reported attention declined in patients with brain metastases after RT to the brain, whereas it remained relatively stable in breast cancer patients.

• Authors: Ansa Maer Cole, Angela Scherwath, Gundula Ernst, Heinrich Lanfermann, Michael Bremer, Diana Steinmann
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 87 Issue 4 Pg. 705-12 (Nov 15 2013) ISSN: 1879-355X [Electronic] United States
• PMID: 24064320 (Publication Type: Comparative Study, Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Topics

• Activities of Daily Living
• Adult
• Aged
• Attention (physiology, radiation effects)
• Brain Neoplasms (psychology, radiotherapy, secondary)
• Breast Neoplasms (psychology, radiotherapy)
• Cognition (physiology, radiation effects)
• Cognition Disorders (etiology, physiopathology)
• Cranial Irradiation (adverse effects, methods)
• Fatigue (etiology, physiopathology)
• Female
• Humans
• Karnofsky Performance Status
• Male
• Memory (physiology, radiation effects)
• Mental Processes (physiology, radiation effects)
• Middle Aged
• Motivation (physiology, radiation effects)
• Prospective Studies
• Psychometrics
• Self Report
• Surveys and Questionnaires
• Time Factors