Cognitive functioning after radiotherapy or chemoradiotherapy for head-and-neck cancer.
OBJECTIVE
To perform a comprehensive cognitive function (CF) assessment in patients who were relapse free after curative intent radiotherapy (RT) or chemoradiotherapy for squamous cell carcinoma of the head and neck.


METHODS
Patients underwent neuropsychological tests to assess their objective CF; completed questionnaires to assess subjective CF, quality of life, and affect; and underwent blood tests to assess hematologic, biochemical, endocrine, and cytokine status. Retrospectively, the dosimetry of incidental radiation to the brain was determined for all patients, and the dose intensity of cisplatin was determined in those who had undergone chemoradiotherapy.


RESULTS
A total of 10 patients were enrolled (5 treated with radiotherapy only and 5 with radiotherapy and cisplatin). The mean time from the end of treatment was 20 months (range, 9-41). All patients were able to complete the assessment protocol. Of the 10 patients, 9 had impaired objective CF, with memory the most severely affected. The severity of memory impairment correlated significantly with the radiation dose to the temporal lobes, and impaired dexterity correlated significantly with the radiation dose to the cerebellum, suggesting that these deficits might be treatment related. Patients receiving cisplatin appeared to have poorer objective CF than patients receiving only RT, although this difference did not achieve statistical significance, likely owing to the small sample size. Consistent with the published data, objective CF did not correlate with subjective CF or quality of life. No association was found between objective CF and patients' affect, hematologic, biochemical, endocrine, and cytokine status.


CONCLUSIONS
Neuropsychological testing is feasible in squamous cell carcinoma of the head-and-neck survivors. The findings were suggestive of treatment-related cognitive dysfunction. These results warrant additional investigation.
Gan
Hui K
HK
Department of Medical Oncology, Princess Margaret Hospital, Toronto, ON, Canada.
Bernstein
Lori J
LJ
Brown
Jennifer
J
Ringash
Jolie
J
Vakilha
Mehrdad
M
Wang
Lisa
L
Goldstein
David
D
Kim
John
J
Hope
Andrew
A
O'Sullivan
Brian
B
Waldron
John
J
Abdul Razak
Albiruni R
AR
Chen
Eric X
EX
Siu
Lillian L
LL
D000339:Affect / Q000187:drug effects / Q000502:physiology / Q000528:radiation effects; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002277:Carcinoma / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell; D002531:Cerebellum / Q000187:drug effects / Q000528:radiation effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D003071:Cognition / Q000187:drug effects / Q000502:physiology / Q000528:radiation effects; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D007822:Laryngeal Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D009483:Neuropsychological Tests; D010610:Pharyngeal Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D011446:Prospective Studies; D011788:Quality of Life; D000077195:Squamous Cell Carcinoma of Head and Neck; D013702:Temporal Lobe / Q000187:drug effects / Q000528:radiation effects
D000970:Antineoplastic Agents; D002945:Cisplatin