title: Cognitive outcome after radiotherapy in brain tumor.
abstract: OBJECTIVE
  Survival of brain tumor patients has increased with improvements in cancer treatments. However, treatments like radiotherapy can be neurotoxic and thus new end-points in clinical trials, as well as in individual management, have appeared. This article reviews the cognitive outcomes after radiotherapy in brain tumor patients, focusing on radiation-induced impairments, and then discusses actual cognitive assessment limitations.
  
  
  RESULTS
  Although physiopathology of radiation-induced cognitive impairments remains elusive, a general course can be described as acute, early-delayed, and late-delayed effects corresponding to different processes. The last is of high interest because the related impairments are irreversible. In this context, a cognitive assessment should be performed as often as possible, but actual tools are unfortunately not developed. Nevertheless, with respect to neuro-oncologic specificities, new cognitive tools could be developed to overcome these limitations.
  
  
  CONCLUSIONS
  Improvements in neuropsychologic assessment for brain tumor patients are urgently needed. A dynamic vision of radiation-induced cognitive impairments appears inevitable and should lead to a change in actual considerations about neurotoxicity follow-up.
authors.affiliation: aUMR 8257 Cognition And Action Group, Université Paris Descartes, Centre National de la Recherche Scientifique, Service de Santé des Armée, Paris bInstitut de Radioprotection et de Sureté nucléaire, Fontenay-Aux-Roses cInstitut Gustave Roussy, Villejuif dHôpital d'instruction des armées du Val-De-Grâce, Service de Neurologie, Paris eCentre de Lutte contre le Cancer Paul-Strauss, Strasbourg fHôpital de la Pitié-Salpêtrière, Service de Neuro-Oncologie Mazarin, Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Durand
authors.forename: Marie-Odile
authors.initials: MO
authors.lastname: Bernier
authors.forename: Isabelle
authors.initials: I
authors.lastname: Léger
authors.forename: Hervé
authors.initials: H
authors.lastname: Taillia
authors.forename: Georges
authors.initials: G
authors.lastname: Noël
authors.forename: Dimitri
authors.initials: D
authors.lastname: Psimaras
authors.forename: Damien
authors.initials: D
authors.lastname: Ricard
mesh_terms: D001921:Brain / Q000528:radiation effects*; D001932:Brain Neoplasms / Q000532:radiotherapy*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D016371:Cranial Irradiation / Q000009:adverse effects*; D006801:Humans; D011832:Radiation Injuries / Q000175:diagnosis* / Q000517:prevention & control