Klein M, Heimans J J, Aaronson N K, Postma T J, Muller M, van der Ploeg H M, Taphoorn M J B
Afd. Medische Psychologie, Vrije Universiteit Medisch Centrum, Van der Boechorststraat 7, 1081 BT Amsterdam.
Ned Tijdschr Geneeskd. 2004 Oct 30;148(44):2175-80.
To determine the effects of radiotherapy and other medical interventions on cognitive functioning in patients with a low-grade glioma (LGG).
Cross-sectional study.
A total of 195 LGG patients, of whom 104 had received radiotherapy 1-22 years previously, were compared to 100 patients with a low-grade haematological malignancy and 195 healthy controls. The analysis was aimed at differentiating between the effects of the tumour (disease duration, lateralisation) and treatment effects (neurosurgery, radiotherapy, use of anticonvulsants) on cognitive function and the relative risk of cognitive disability.
LGG patients had lower performance levels in all cognitive domains than haematological patients and performed even worse when they were compared to healthy controls. Radiotherapy was associated with poorer cognitive functioning; however, cognitive disability was found only in patients receiving fractional doses exceeding 2 Gy. The use of anticonvulsants was strongly associated with disorders in the area of attention and planning functions.
In this study, the tumour itself was the most damaging factor with respect to cognitive function and radiotherapy was associated with cognitive disability only if elevated fractional doses were used. Epilepsy or the use of anticonvulsants was also associated with diminished cognitive functioning.
确定放疗及其他医学干预措施对低级别胶质瘤（LGG）患者认知功能的影响。
横断面研究。
将195例LGG患者（其中104例在1至22年前接受过放疗）与100例低级别血液系统恶性肿瘤患者及195名健康对照者进行比较。该分析旨在区分肿瘤（疾病持续时间、病变部位）和治疗效果（神经外科手术、放疗、使用抗惊厥药物）对认知功能的影响以及认知障碍的相对风险。
LGG患者在所有认知领域的表现水平均低于血液系统疾病患者，与健康对照者相比表现更差。放疗与较差的认知功能相关；然而，仅在接受分次剂量超过2 Gy的患者中发现认知障碍。使用抗惊厥药物与注意力和计划功能方面的障碍密切相关。
在本研究中，肿瘤本身是对认知功能最具损害的因素，仅当使用较高分次剂量放疗时才与认知障碍相关。癫痫或使用抗惊厥药物也与认知功能减退有关。
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