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Neurocognitive Function of Patients with Brain Metastasis Who Received Either Whole Brain Radiotherapy Plus Stereotactic Radiosurgery or Radiosurgery Alone

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Title: Neurocognitive Function of Patients with Brain Metastasis Who Received Either Whole Brain Radiotherapy Plus Stereotactic Radiosurgery or Radiosurgery Alone
Authors: Aoyama, Hidefumi Browse this author
Tago, Masao Browse this author
Kato, Norio Browse this author
Toyoda, Tatsuya Browse this author
Kenjyo, Masahiro Browse this author
Hirota, Saeko Browse this author
Shioura, Hiroki Browse this author
Inomata, Taisuke Browse this author
Kunieda, Etsuo Browse this author
Hayakawa, Kazushige Browse this author
Nakagawa, Keiichi Browse this author
Kobashi, Gen Browse this author
Shirato, Hiroki Browse this author
Keywords: Brain metastasis
Radiosurgery
Whole brain radiotherapy
Neurocognitive function
Leukoencephalopathy
Issue Date: 1-Aug-2007
Publisher: Elsevier Inc.
Journal Title: International Journal of Radiation Oncology 'Biology' Physics
Volume: 68
Issue: 5
Start Page: 1388
End Page: 1395
Publisher DOI: 10.1016/j.ijrobp.2007.03.048
PMID: 17674975
Abstract: Purpose: To determine how the omission of whole brain radiotherapy (WBRT) affects the neurocognitive function of patients with one to four brain metastases who have been treated with stereotactic radiosurgery (SRS). Methods and Materials: In a prospective randomized trial between WBRT+SRS and SRS alone for patients with one to four brain metastases, we assessed the neurocognitive function using the Mini-Mental State Examination (MMSE). Of the 132 enrolled patients, MMSE scores were available for 110. Results: In the baseline MMSE analyses, statistically significant differences were observed for total tumor volume, extent of tumor edema, age, and Karnofsky performance status. Of the 92 patients who underwent the follow-up MMSE, 39 had a baseline MMSE score of ≤27 (17 in the WBRT+SRS group and 22 in the SRS-alone group). Improvements of ≥3 points in the MMSEs of 9 WBRT+SRS patients and 11 SRS-alone patients (p = 0.85) were observed. Of the 82 patients with a baseline MMSE score of ≥27 or whose baseline MMSE score was ≤26 but had improved to ≥27 after the initial brain treatment, the 12-, 24-, and 36-month actuarial free rate of the 3-point drop in the MMSE was 76.1%, 68.5%, and 14.7% in the WBRT+SRS group and 59.3%, 51.9%, and 51.9% in the SRS-alone group, respectively. The average duration until deterioration was 16.5 months in the WBRT+SRS group and 7.6 months in the SRS-alone group (p = 0.05). Conclusion: The results of the present study have revealed that, for most brain metastatic patients, control of the brain tumor is the most important factor for stabilizing neurocognitive function. However, the long-term adverse effects of WBRT on neurocognitive function might not be negligible.
Relation: http://www.sciencedirect.com/science/journal/03603016
Type: article (author version)
URI: http://hdl.handle.net/2115/30164
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 青山 英史

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