Mid-term treatment-related cognitive sequelae in glioma patients View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2022-07-07

AUTHORS

Sabine Schlömer, Jörg Felsberg, Milena Pertz, Bettina Hentschel, Markus Löffler, Gabriele Schackert, Dietmar Krex, Tareq Juratli, Joerg Christian Tonn, Oliver Schnell, Hartmut Vatter, Matthias Simon, Manfred Westphal, Tobias Martens, Michael Sabel, Martin Bendszus, Nils Dörner, Klaus Fliessbach, Christian Hoppe, Guido Reifenberger, Michael Weller, Uwe Schlegel, for the German Glioma Network

ABSTRACT

PurposeCognitive functioning represents an essential determinant of quality of life. Since significant advances in neuro-oncological treatment have led to prolonged survival it is important to reliably identify possible treatment-related neurocognitive dysfunction in brain tumor patients. Therefore, the present study specifically evaluates the effects of standard treatment modalities on neurocognitive functions in glioma patients within two years after surgery.MethodsEighty-six patients with World Health Organization (WHO) grade 1–4 gliomas were treated between 2004 and 2012 and prospectively followed within the German Glioma Network. They received serial neuropsychological assessment of attention, memory and executive functions using the computer-based test battery NeuroCog FX. As the primary outcome the extent of change in cognitive performance over time was compared between patients who received radiotherapy, chemotherapy or combined radio-chemotherapy and patients without any adjuvant therapy. Additionally, the effect of irradiation and chemotherapy was assessed in subgroup analyses. Furthermore, the potential impact of the extent of tumor resection and histopathological characteristics on cognitive functioning were referred to as secondary outcomes.ResultsAfter a median of 16.8 (range 5.9–31.1) months between post-surgery baseline neuropsychological assessment and follow-up assessment, all treatment groups showed numerical and often even statistically significant improvement in all cognitive domains. The extent of change in cognitive functioning showed no difference between treatment groups. Concerning figural memory only, irradiated patients showed less improvement than non-irradiated patients (p = 0.029, η2 = 0.06). Resected patients, yet not patients with biopsy, showed improvement in all cognitive domains. Compared to patients with astrocytomas, patients with oligodendrogliomas revealed a greater potential to improve in attentional and executive functions. However, the heterogeneity of the patient group and the potentially selected cohort may confound results.ConclusionWithin a two-year post-surgery interval, radiotherapy, chemotherapy or their combination as standard treatment did not have a detrimental effect on cognitive functions in WHO grade 1–4 glioma patients. Cognitive performance in patients with adjuvant treatment was comparable to that of patients without. More... »

PAGES

65-79

Journal

TITLE

Journal of Neuro-Oncology

ISSUE

1

VOLUME

159

Author Affiliations

  • Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, In der Schornau 23-25, D-44892, Bochum, Germany
  • Institute of Neuropathology, Heinrich Heine University Medical Faculty and University Hospital Düsseldorf, Düsseldorf, Germany
  • Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
  • Department of Neurosurgery, University Hospital, University Carl Gustav Carus of Dresden, Dresden, Germany
  • Department of Neurosurgery, University Hospital, Ludwig Maximilians University of Munich, Munich, Germany
  • Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany
  • Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
  • Department of Neurosurgery, Medical Center Bethel, University Hospital Bielefeld, Bielefeld, Germany
  • Department of Neurosurgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
  • Department of Neurosurgery, Medical Center Asklepios St. Georg, Hamburg, Germany
  • Department of Neurosurgery, Heinrich Heine University Medical Faculty and University Hospital Düsseldorf, Düsseldorf, Germany
  • Department of Neuroradiology, Medical Center of Neurology, University Hospital Heidelberg, Heidelberg, Germany
  • Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
  • Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
  • Department of Epileptology, University Hospital Bonn, Bonn, Germany
  • Department of General Neurology, University Hospital Tübingen, Tübingen, Germany
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11060-022-04044-1

    DOI

    http://dx.doi.org/10.1007/s11060-022-04044-1

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1149305660

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/35796933


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