Department of Radiation Oncology, Nizam's Institute of Medical Sciences, Hyderabad, India.
Department of Radiation Oncology, Nizam's Institute of Medical Sciences, Hyderabad, India.
Cancer Treat Res Commun. 2021;26:100288. doi: 10.1016/j.ctarc.2020.100288. Epub 2020 Dec 19.
Neurocognitive functioning (NCF) is an important component of quality of life (QoL) in glioma patients. The neurocognitive toxicity from irradiation of brain tumours may be related to damage to neural progenitor cells (NPC). The aim of our study was to assess the NCF in illiterate glioma patients.
This was a prospective study done in glioma patients admitted for adjuvant treatment. Illiterate and semiliterate post op glioma patients with ECOG PS ≤ 3 were included. Neurocognitive assessment was done using Addenbrooke's Cognitive Examination (ACE-III) questionnaire prior to the start of RT and at 6month and 12 month follow up. The scores were correlated to the doses to sub ventricular zone (SVZ) and sub granular zone (SGZ) regions.
20 patients were recruited.16 patients were illiterate and four patients were semiliterate. Median of the mean dose to the SVZ I/L (ipsilateral) was 48.5 Gy and SGZ I/L was 39.5 Gy. In patients who received ≤49 Gy mean dose to SVZ I/L, there was statistically significant improvement in memory, fluency, language and total ACE scores at six months. In patients with SGZ I/L mean dose ≤40 Gy, there was improvement in memory, language, and total ACE score at six months. Similar trend continued at 12 months follow up.
NCF assessment by ACE III questionnaire is a useful tool even in illiterate patients. Lower RT doses to the ipsilateral SVZ and SGZ showed significant improvement in total ACE scores at 6 months and improvement in specific domains at 6 and 12 months.
神经认知功能（NCF）是胶质瘤患者生活质量（QoL）的重要组成部分。脑肿瘤照射的神经认知毒性可能与神经祖细胞（NPC）损伤有关。我们的研究目的是评估文盲胶质瘤患者的 NCF。
这是一项对接受辅助治疗的胶质瘤患者进行的前瞻性研究。纳入 ECOG PS≤3 的术后文盲和半文盲胶质瘤患者。在开始放疗前和 6 个月及 12 个月随访时，使用 Addenbrooke's 认知评估（ACE-III）问卷进行神经认知评估。将评分与脑室下区（SVZ）和颗粒下区（SGZ）的剂量相关联。
共招募了 20 名患者。16 名患者为文盲，4 名患者为半文盲。SVZ I/L（对侧）的平均剂量中位数为 48.5Gy，SGZ I/L 的平均剂量中位数为 39.5Gy。在接受≤49Gy 平均剂量 SVZ I/L 的患者中，6 个月时记忆、流畅性、语言和总 ACE 评分有统计学意义的改善。在 SGZ I/L 平均剂量≤40Gy 的患者中，6 个月时记忆、语言和总 ACE 评分有所改善。在 12 个月的随访中，这种趋势仍在继续。
即使在文盲患者中，使用 ACE III 问卷进行 NCF 评估也是一种有用的工具。SVZ 和 SGZ 的对侧 RT 剂量较低，6 个月时总 ACE 评分显著提高，6 个月和 12 个月时特定领域的评分提高。
