[Assessment of cognitive function after preventive and therapeutic whole brain irradiation using neuropsychological testing].
OBJECTIVE
Aim of this study was the assessment of neuropsychological changes after whole brain irradiation.


METHODS
64 patients were tested before, and 29 after whole brain irradiation, including 28 patients with small cell lung cancer (SCLC) before prophylactic cranial irradiation (PCI) and 36 patients with cerebral metastases before therapeutic cranial irradiation (TCI), as well as 14 patients after PCI and 15 after TCI (Table 1). Intelligence, attention and memory were assessed applying a 90-minute test battery of standardized, neuropsychological tests (Table 3).


RESULTS
Patients with SCLC showed test results significantly below average before PCI (n = 28, mean IQ = 83, SD = 17). Neither after PCI, nor after TCI the tested neuropsychological functions decreased significantly (Tables 4, 5). A comparison between SCLC-patients with and without cerebral metastases before whole brain irradiation showed better test-results in patients with cerebral metastases and fewer cycles of preceding chemotherapy (Table 7).


CONCLUSIONS
Neuropsychological capacity in patients with SCLC was impaired even before PCI. Possible reason is the preceding chemotherapy. Whole brain irradiation did not induce a significant decline of cognitive functions in patients with PCI or TCI. A decline in a longer follow-up nevertheless seems possible.
Penitzka
Susanne
S
Abteilung Klinische Radiologie, Universitätsklinikum Heidelberg. Susanne_Oertel@med.uni-heidelberg.de
Steinvorth
Sarah
S
Sehlleier
Simone
S
Fuss
Martin
M
Wannenmacher
Michael
M
Wenz
Frederik
F
D000328:Adult; D000368:Aged; D001288:Attention / Q000528:radiation effects; D001921:Brain / Q000528:radiation effects*; D001925:Brain Damage, Chronic / Q000175:diagnosis*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary*; D018288:Carcinoma, Small Cell / Q000532:radiotherapy / Q000556:secondary; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003072:Cognition Disorders / Q000175:diagnosis*; D003131:Combined Modality Therapy; D016371:Cranial Irradiation / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007360:Intelligence / Q000528:radiation effects; D008175:Lung Neoplasms / Q000532:radiotherapy; D008297:Male; D011939:Mental Recall / Q000528:radiation effects; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011832:Radiation Injuries / Q000175:diagnosis*