Laack Nadia N, Brown Paul D, Ivnik Robert J, Furth Alfred F, Ballman Karla V, Hammack Julie E, Arusell Robert M, Shaw Edward G, Buckner Jan C
Division of Radiation Oncology, Mayo Clinic, Rochester, MN 55905, USA.
Int J Radiat Oncol Biol Phys. 2005 Nov 15;63(4):1175-83. doi: 10.1016/j.ijrobp.2005.04.016. Epub 2005 Jun 20.
To evaluate the effects of cranial radiotherapy (RT) on cognitive function in patients with supratentorial low-grade glioma.
Twenty adult patients with supratentorial low-grade glioma were treated with 50.4 Gy (10 patients) or 64.8 Gy (10 patients) localized RT. The patients then were evaluated with an extensive battery of psychometric tests at baseline (before RT) and at approximately 18-month intervals for as long as 5 years after completing RT. To allow patients to serve as their own controls, cognitive performance was evaluated as change in scores over time. All patients underwent at least two evaluations.
Baseline test scores were below average compared with age-specific norms. At the second evaluation, the groups' mean test scores were higher than their initial performances on all psychometric measures, although the improvement was not statistically significant. No changes in cognitive performance were seen during the evaluation period when test scores were analyzed by age, treatment, tumor location, tumor type, or extent of resection.
Cognitive function was stable after RT in these patients evaluated prospectively during 3 years of follow-up. Slight improvements in some cognitive areas are consistent with practice effects attributable to increased familiarity with test procedures and content.
评估颅部放疗(RT)对幕上低级别胶质瘤患者认知功能的影响。
20例幕上低级别胶质瘤成年患者接受了50.4 Gy(10例患者)或64.8 Gy(10例患者)的局部放疗。然后在基线期(放疗前)以及放疗结束后长达5年的时间里,每隔约18个月对患者进行一系列广泛的心理测量测试评估。为使患者作为自身对照,认知表现以分数随时间的变化来评估。所有患者至少接受了两次评估。
与特定年龄的正常标准相比,基线测试分数低于平均水平。在第二次评估时,两组的平均测试分数在所有心理测量指标上均高于其初始表现,尽管改善无统计学意义。当按年龄、治疗、肿瘤位置、肿瘤类型或切除范围分析测试分数时,在评估期内未观察到认知表现的变化。
在为期3年的随访中对这些患者进行前瞻性评估,放疗后认知功能稳定。某些认知领域的轻微改善与因对测试程序和内容更加熟悉而产生的练习效应一致。