The University of Texas Health Science Center at Houston, Vivian L. Smith Department of Neurosurgery and Mischer Neuroscience Institute, Houston, TX, United States.
Icahn School of Medicine at Mount Sinai, New York City, NY, United States.
Cancer Treat Rev. 2018 Apr;65:33-40. doi: 10.1016/j.ctrv.2018.02.007. Epub 2018 Mar 2.
Cognitive dysfunction is common among patients with intracranial tumors. Most cognitive deficits are subtle, lack specificity, may mimic depression or other neurological disorders and may be recognized in retrospect by the physician. In certain cases, distinguishing between tumor recurrence and cognitive deficits that arise as a consequence of the treatment becomes challenging. Late treatment effects have also become an area of focus as the overall survival and prognosis of patients with brain tumors increases. New data has highlighted the importance of less toxic adjuvant therapies owing to their positive impact on prognosis and quality of life. Various experimental therapies and genetic influences on individual sensitivity towards injury are promising steps towards a better management strategy for cognitive dysfunction. In this literature review, we discuss cognitive dysfunction as a manifestation of intracranial tumors, treatment modalities such as radiotherapy, chemotherapy, surgery and their impact on cognition and patients' quality of life. We also discuss management options for cognitive dysfunction and emerging therapies.
认知功能障碍在颅内肿瘤患者中很常见。大多数认知缺陷较为微妙,缺乏特异性,可能类似于抑郁症或其他神经疾病,并且可能会被医生事后识别。在某些情况下,区分肿瘤复发和因治疗而产生的认知缺陷变得具有挑战性。随着脑肿瘤患者的总生存和预后的提高,迟发性治疗效应也成为一个关注的领域。由于其对预后和生活质量的积极影响,新的数据突显了毒性较小的辅助治疗的重要性。各种实验治疗方法和个体对损伤敏感性的遗传影响是朝着更好的认知功能障碍管理策略迈出的有希望的步骤。在这篇文献综述中,我们讨论了作为颅内肿瘤表现的认知功能障碍、放疗、化疗、手术等治疗方式及其对认知和患者生活质量的影响。我们还讨论了认知功能障碍的治疗选择和新兴治疗方法。