CogState computerized memory tests in patients with brain metastases: secondary endpoint results of NRG Oncology RTOG 0933.
Whole brain radiotherapy (WBRT) is associated with memory dysfunction. As part of NRG Oncology RTOG 0933, a phase II study of WBRT for brain metastases that conformally avoided the hippocampal stem cell compartment (HA-WBRT), memory was assessed pre- and post-HA-WBRT using both traditional and computerized memory tests. We examined whether the computerized tests yielded similar findings and might serve as possible alternatives for assessment of memory in multi-institution clinical trials. Adult patients with brain metastases received HA-WBRT to 30 Gy in ten fractions and completed Hopkins Verbal Learning Test-Revised (HVLT-R), CogState International Shopping List Test (ISLT) and One Card Learning Test (OCLT), at baseline, 2 and 4 months. Tests' completion rates were 52-53 % at 2 months and 34-42 % at 4 months. All baseline correlations between HVLT-R and CogState tests were significant (p ≤ 0.003). At baseline, both CogState tests and one component of HVLT-R differentiated those who were alive at 6 months and those who had died (p ≤ 0.01). At 4 months, mean relative decline was 7.0 % for HVLT-R Delayed Recall and 18.0 % for ISLT Delayed Recall. OCLT showed an 8.0 % increase. A reliable change index found no significant changes from baseline to 2 and 4 months for ISLT Delayed Recall (z = -0.40, p = 0.34; z = -0.68, p = 0.25) or OCLT (z = 0.15, p = 0.56; z = 0.41, p = 0.66). Study findings support the possibility that hippocampal avoidance may be associated with preservation of memory test performance, and that these computerized tests also may be useful and valid memory assessments in multi-institution adult brain tumor trials.
Neurosciences Institute, Intermountain Medical Center, 5171 Cottonwood Street, 8th Floor, Murray, UT, 84107, USA. chip.caine@imail.org.|University of Phoenix, Utah Campus, 5373 S 360 W, Salt Lake City, UT, 84123, USA. chip.caine@imail.org.
Chip
C
Caine
NRG Oncology Statistics and Data Management Center, 1818 Market Street, Suite 1600, Philadelphia, PA, 19103, USA.
Snehal
S
Deshmukh
Northwestern Medicine Cancer Center, Warrenville and Northwestern Chicago Proton Center, 4455 Weaver Parkway, Warrenville, IL, 60555, USA.|Department of Human Oncology, UW-Madison School of Medicine and Public Health, 600 Highland Avenue, K4/334-3684, Madison, WI, 53792, USA.
Vinai
V
Gondi
Department of Radiation Oncology, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD, 21201, USA.
Minesh
M
Mehta
Montefiore Medical Center and Albert Einstein College of Medicine of Yeshiva University, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
Wolfgang
W
Tomé
Institute of Radiotherapy, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel.
Benjamin W
BW
Corn
Institute of Radiotherapy, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel.
Andrew
A
Kanner
Department of Radiation Oncology, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD, 21201, USA.
Howard
H
Rowley
Saskatoon Cancer Centre, 20 Campus Drive, Saskatoon, SK, S7N 4H4, Canada.
Vijayananda
V
Kundapur
Main Line CCOP, Lankenau Medical Center, 100 Lancaster Ave: 4 MSB, Suite 4430, Wynnewood, PA, 19096, USA.
Albert
A
DeNittis
Juravinski Cancer Centre, McMaster University-Hamilton, 699 Concession St., Hamilton, ON, L8V 5C2, Canada.
Jeffrey Noah
JN
Greenspoon
The Chester County Hospital, 440 East Marshall Street, Suite 201, West Chester, PA, 19380, USA.
Andre A
AA
Konski
Department of Oncology, London Regional Cancer Program, 790 Commissioners Road East, London, ON, N6A 4L6, Canada.
Glenn S
GS
Bauman
Christiana Care Health Services, CCOP, Helen F. Graham Cancer Center & Research Institute, 4701 Ogletown-Stanton Rd., S-1110, Newark, DE, 19713, USA.
Adam
A
Raben
Bodine Center, Thomas Jefferson University Hospital, 111 South 11th Street, Philadelphia, PA, 19107, USA.
Wenyin
W
Shi
Willamette Valley Cancer Institute, 520 Country Club Road, Eugene, OR, 97401, USA.
Merideth
M
Wendland
Department of Radiation Oncology, Boston Medical Center MBCCOP, 830 Harrison Avenue, Boston, MA, 02118, USA.
Lisa
L
Kachnic
D001932:Brain Neoplasms / Q000523:psychology* / Q000532:radiotherapy* / Q000556:secondary*; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000528:radiation effects*; D011939:Mental Recall / Q000528:radiation effects; D008875:Middle Aged; D009483:Neuropsychological Tests; D011832:Radiation Injuries / Q000523:psychology*; D014706:Verbal Learning / Q000528:radiation effects
HVLT-R; ISLT; NRG Oncology RTOG 0933; Neurocognitive; OCLT