Neuropsychological function in adults after high dose fractionated radiation therapy of skull base tumors.
OBJECTIVE
To evaluate the long term effects of high dose fractionated radiation therapy on brain functioning prospectively in adults without primary brain tumors.


METHODS
Seventeen patients with histologically confirmed chordomas and low grade chondrosarcomas of the skull base were evaluated with neuropsychological measures of intelligence, language, memory, attention, motor function and mood following surgical resection/biopsy of the tumor prior to irradiation, and then at about 6 months, 2 years and 4 years following completion of treatment. None received chemotherapy.


RESULTS
In the patients without tumor recurrence or radiation necrosis, there were no indications of adverse effects on cognitive functioning in the post-acute through the late stages after brain irradiation. Even in patients who received doses of radiation up to 66 Cobalt Gy equivalent through nondiseased (temporal lobe) brain tissue, memory and cognitive functioning remained stable for up to 5 years after treatment. A mild decline in psychomotor speed was seen in more than half of the patients, and motor slowing was related to higher radiation doses in midline and temporal lobe brain structures.


CONCLUSIONS
Results suggest that in adults, tolerance for focused radiation is relatively high in cortical brain structures.
Glosser
G
G
Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia 19104-4283, USA. glosser@mail.med.upenn.edu
McManus
P
P
Munzenrider
J
J
Austin-Seymour
M
M
Fullerton
B
B
Adams
J
J
Urie
M M
MM
D000328:Adult; D001921:Brain / Q000528:radiation effects*; D002813:Chondrosarcoma / Q000503:physiopathology / Q000523:psychology* / Q000532:radiotherapy; D002817:Chordoma / Q000503:physiopathology / Q000523:psychology* / Q000532:radiotherapy; D016371:Cranial Irradiation; D005260:Female; D006801:Humans; D007858:Learning / Q000528:radiation effects; D008297:Male; D008606:Mental Processes / Q000528:radiation effects*; D008875:Middle Aged; D015999:Multivariate Analysis; D009484:Neuropsychology; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000528:radiation effects; D019292:Skull Base Neoplasms / Q000503:physiopathology / Q000523:psychology* / Q000532:radiotherapy