Cognitive functions in primary central nervous system lymphoma: literature review and assessment guidelines.
BACKGROUND
Treatment-related neurotoxicity has been recognized as a significant problem in patients with primary central nervous system lymphoma (PCNSL) as effective treatment has increased survival rates. There is, however, a paucity of research on cognitive functions in this population.


METHODS
In a review of the literature, a total of 17 articles that described cognitive outcome in adult PCNSL patients were identified.


RESULTS
The studies that assessed cognitive functions after whole-brain radiotherapy combined with chemotherapy reported cognitive impairment in most patients. Patients treated with chemotherapy alone had either stable or improved cognitive performance in most studies. Methodological problems, however, limited the ability to ascertain the specific contribution of disease and various treatment interventions to cognitive outcome. On the basis of the literature review, a battery of cognitive and quality-of-life (QoL) measures to be used in prospective clinical trials was proposed. The battery is composed of five standardized neuropsychological tests, covering four domains sensitive to disease and treatment effects (attention, executive functions, memory, psychomotor speed), and QoL questionnaires, and meets criteria for use in collaborative trials.


CONCLUSIONS
The incorporation of formal and systematic cognitive evaluations in PCNSL studies will improve our understanding of treatment-related neurotoxicity in this population.
Correa
D D
DD
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. corread@mskcc.org
Maron
L
L
Harder
H
H
Klein
M
M
Armstrong
C L
CL
Calabrese
P
P
Bromberg
J E C
JE
Abrey
L E
LE
Batchelor
T T
TT
Schiff
D
D
D000970:Antineoplastic Agents / Q000009:adverse effects*; D001921:Brain / Q000187:drug effects / Q000528:radiation effects; D016543:Central Nervous System Neoplasms / Q000628:therapy*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D003131:Combined Modality Therapy; D006801:Humans; D008223:Lymphoma / Q000628:therapy*; D009483:Neuropsychological Tests; D020258:Neurotoxicity Syndromes / Q000175:diagnosis / Q000209:etiology; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects*
D000970:Antineoplastic Agents