Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Appl Neuropsychol Adult. 2024 Jul-Aug;31(4):606-615. doi: 10.1080/23279095.2022.2048830. Epub 2022 Mar 27.
Infiltrative non-GBM gliomas are common primary intracranial malignancies, and postoperative adjuvant radiotherapy is recommended for most adult patients diagnosed with this disease to enhance local control and prolong intracranial progression-free survival (PFS). However, RT-related neurocognitive function (NCF) consequences should not be ignored. Early neurocognitive decline principally includes episodic memory, associated significantly with functions of the hippocampus. This prospective study aims to investigate the impact of adjuvant brain irradiation on neurocognitive performances and relevant oncological outcomes.Twenty-five patients with intracranial infiltrative non-GBM gliomas were enrolled when postoperative adjuvant RT was recommended. All recruited patients should receive baseline brain magnetic resonance imaging, and neuropsychological assessments before and 4 months after the RT course. A battery of neuropsychological measures, mainly including executive functions, memory, psychomotor speed and visuoconstructive ability, was used to evaluate NCFs of interest.Analyzing the delta values between post-irradiation and baseline NCF scores, we observed a robust trend reflecting cognitive stabilization rather than deterioration in almost all NCF. Both verbal and visual memory functions exhibited significant differences in the corresponding scaled scores ( = -2.722, = .006, regarding verbal memory; = -2.246, = .025, concerning non-verbal memory). Moreover, patients' neuropsychological performances associated with psychomotor speed and executive functions also disclosed a tendency toward stabilization/improvement.This prospective study demonstrated that patients with infiltrative non-GBM exhibited a marked tendency toward neurocognitive stabilization after receiving postoperative adjuvant RT. Trial Registration with ClinicalTrials.gov identifier: NCT03534050.
浸润性非胶质母细胞瘤是常见的原发性颅内恶性肿瘤，大多数确诊该病的成年患者术后都需要辅助放疗，以提高局部控制率并延长颅内无进展生存期（PFS）。然而，不应忽视放疗相关的神经认知功能（NCF）后果。早期神经认知衰退主要包括情景记忆，与海马功能显著相关。本前瞻性研究旨在探讨辅助脑部放疗对神经认知表现和相关肿瘤学结局的影响。
当推荐术后辅助放疗时，共纳入 25 例颅内浸润性非胶质母细胞瘤患者。所有入组患者均应在放疗前和放疗后 4 个月接受脑部磁共振成像和神经心理学评估。一套神经心理学测试，主要包括执行功能、记忆、精神运动速度和视觉空间构建能力，用于评估 NCF。
分析放疗后与基线 NCF 评分的差值，我们观察到一个几乎所有 NCF 都趋于稳定而非恶化的显著趋势。在相应的量表评分中，言语和视觉记忆功能都有显著差异（= -2.722，=.006，与言语记忆有关；= -2.246，=.025，与非言语记忆有关）。此外，与精神运动速度和执行功能相关的患者神经心理表现也显示出稳定/改善的趋势。
这项前瞻性研究表明，浸润性非胶质母细胞瘤患者在接受术后辅助放疗后，神经认知有明显的稳定趋势。临床试验注册号：NCT03534050。
