Neurocognitive function impairment after whole brain radiotherapy for brain metastases: actual assessment

Radiation Oncology

Table 2 Time, NCF domain impaired, and incidence of NC impairment after WBRT

Study	Radiation scheme	Nb	Assessment time					Domains impaired	Impairment definition
				% of patients impaired
			1 mo	2 mo	3 mo	5 mo	12 mo
Sun et al., 2011 [19]	PCI 30Gy/15 fr	163						^§HVLT
			_	_	45%		26%	Recall
					44%		32%	Delayed recall
Meyers et al., 2004 [22]	30 Gy/ 10fr ± MGd	401	_	_	31%	_		^*Pegboard	>2 DS
					7%			^†COWA	>2 DS
	30Gy/10fr alone	208					48%	^§HVLT	≥ 4.5 DS
							48%	^†COWA	≥ 4.5 DS
Chang et al., 2009 [13]	SRS + WBRT (30 Gy/12 fractions)	28			64%	28%		^§HVLT	Drop ≥ 5 points
					22%			Delayed recall
					11%			Delayed recognition
Welzel et al., 2008 [27]	TCI: 40Gy/20fr	16	9%		_	_	_	^§MCG	RCI (≥1score)
			18%	43%				Overall cognitive decline	RCI (≥2/12 test scores)
				57%	_	_	_	^§AVLT	RCI (≥1score)
	PCI: 36Gy/18fr	13	23%		_	_	_	^§MCG	RCI (≥1score)
			8%	11%				Overall cognitive decline	RCI (≥2/12 test scores)
				44%				^§AVLT	RCI (≥1score)
					_
Van Oosterhout et al., 1995 [28]	PCI (30 Gy / 15 fractions)	5	0		_	0	_	none	> ?DS
Komaki et al., 1995 [29]	PCI (25 Gy / 10 fractions)	11	_	_	_	_	0	none	≥ 1.5 DS
Wolfson et al., 2010 [31]	PCI
	25 Gy/10 fr	131					62%	^§HVLT, ^†COWA, ^‡TMT-A and B	Decrease in at least one of the test (from baseline) (RCI)
	36 Gy/18 fr	67					85%
	36 Gy/twice-daily 24fr	66					89%

Only studies from which percentages of patients impaired on NCF could be extracted are reported in this table. PCI = Prophylactic Cranial Irradiation; MGd = Motexafin Gadolinium; ^*Pegboard: grooved pegboard test, examining motor speed and dexterity; ^†COWA: Controlled Oral Word Association, test examining verbal fluency; ^§ HVLT: Hopkins Verbal Learning Test, examining immediate recall, delayed recall, and recognition; MCG: Medical College of Georgia Complex Figures, examining visual memory and visual construction (copy, immediate recall and delayed recall); AVLT: Auditory Verbal Learning Test, examining verbal memory; ^‡TMT-A and B: trailmaking test A, examining visual-motor scanning speed, and B, examining executive functions.

ISSN: 1748-717X