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

Aoyama, Hidefumi; Tago, Masao; Kato, Norio; Toyoda, Tatsuya; Kenjyo, Masahiro; Hirota, Saeko; Shioura, Hiroki; Inomata, Taisuke; Kunieda, Etsuo; Hayakawa, Kazushige; Nakagawa, Keiichi; Kobashi, Gen; Shirato, Hiroki

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

Aoyama, Hidefumi; Tago, Masao; Kato, Norio et al.

International Journal of Radiation Oncology 'Biology' Physics, 2007, 68(5), 1388-1395

Permalink : https://hdl.handle.net/2115/30164

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アクセス権	open access
URI	https://hdl.handle.net/2115/30164
タイトル	Neurocognitive Function of Patients with Brain Metastasis Who Received Either Whole Brain Radiotherapy Plus Stereotactic Radiosurgery or Radiosurgery Alone
著者	Aoyama, Hidefumi ; Tago, Masao ; Kato, Norio ; Toyoda, Tatsuya ; Kenjyo, Masahiro ; Hirota, Saeko ; Shioura, Hiroki ; Inomata, Taisuke ; Kunieda, Etsuo ; Hayakawa, Kazushige ; Nakagawa, Keiichi ; Kobashi, Gen ; Shirato, Hiroki
著者名 Aoyama, Hidefumi
著者名 Tago, Masao
著者名 Kato, Norio
著者名 Toyoda, Tatsuya
著者名 Kenjyo, Masahiro
著者名 Hirota, Saeko
著者名 Shioura, Hiroki
著者名 Inomata, Taisuke
著者名 Kunieda, Etsuo
著者名 Hayakawa, Kazushige
著者名 Nakagawa, Keiichi
著者名 Kobashi, Gen
著者名 Shirato, Hiroki
言語	英語
キーワード	Brain metastasis
	Radiosurgery
	Whole brain radiotherapy
	Neurocognitive function
	Leukoencephalopathy
発行日	2007-08-01
出版者	Elsevier Inc.
収録物名	International Journal of Radiation Oncology 'Biology' Physics
巻(号)	68(5)
ページ	1388-1395
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
PISSN	0360-3016
関連情報	PMID 17674975
関連情報	URI http://www.sciencedirect.com/science/journal/03603016
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.ijrobp.2007.03.048