Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, OH, USA.
Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA.
J Neurooncol. 2022 Jul;158(3):341-348. doi: 10.1007/s11060-022-04019-2. Epub 2022 Apr 29.
We sought to evaluate the effects of concurrent temozolomide-based chemoradiation therapy on neurocognitive function in patients with low-grade glioma (LGG).
MATERIALS/METHODS: We included adult patients with LGG who were treated postoperatively with radiotherapy (RT) with concurrent and adjuvant temozolomide (TMZ). Patients were evaluated with comprehensive psychometric tests at baseline (prior to RT + TMZ) and at various time intervals following RT + TMZ. Baseline cognitive performance was analyzed by sex, age, education history, history of seizures, IDH mutation status, and 1p/19q codeletion status. Changes in neurocognitive performance were evaluated over time.
Thirty-seven LGG patients (mean age 43.6, 59.5% male) had baseline neurocognitive evaluation. Patients with an age > 40 years old at diagnosis and those with an education > 16 years demonstrated superior baseline verbal memory as assessed by HVLT. No other cognitive domains showed differences when stratified by the variables mentioned above. A total of 22 LGG patients had baseline and post RT + TMZ neurocognitive evaluation. Overall, patients showed no statistical difference between group mean test scores prior to and following RT + TMZ on all psychometric measures (with the exception of HVLT Discrimination).
Cognitive function remained stable following RT + TMZ in LGG patients evaluated prospectively up to 2 years. The anticipated analysis of RTOG 0424 will provide valuable neurocognitive outcomes specifically for high risk LGG patients treated with RT + TMZ.
我们旨在评估替莫唑胺同步放化疗对低级别胶质瘤（LGG）患者神经认知功能的影响。
材料/方法：我们纳入了术后接受放疗（RT）联合替莫唑胺（TMZ）治疗的 LGG 成年患者。患者在 RT+TMZ 治疗前（基线）和治疗后不同时间点接受全面的心理测试评估。通过性别、年龄、教育史、癫痫发作史、IDH 突变状态和 1p/19q 联合缺失状态分析基线认知表现。评估神经认知表现随时间的变化。
37 例 LGG 患者（平均年龄 43.6 岁，59.5%为男性）进行了基线神经认知评估。诊断时年龄>40 岁和教育程度>16 年的患者在 HVLT 测试中表现出更好的言语记忆。未发现其他认知域在上述变量分层时存在差异。共有 22 例 LGG 患者进行了基线和 RT+TMZ 后神经认知评估。总体而言，所有心理测试（除 HVLT 判别外）的组平均测试分数在 RT+TMZ 治疗前后均无统计学差异。
前瞻性评估的 LGG 患者在接受 RT+TMZ 治疗后，认知功能保持稳定，随访时间长达 2 年。RTOG 0424 的预期分析将为接受 RT+TMZ 治疗的高危 LGG 患者提供有价值的神经认知结果。
