title: A prospective study on neurocognitive effects after primary radiotherapy in high-grade glioma patients.
abstract: BACKGROUND
  Neurocognition is a very important aspect of a brain tumor patient's quality of life following radiotherapy. The aim of the present study was to assess neurocognitive functions of patients diagnosed with high-grade gliomas undergoing radiotherapy by using the NeuroCogFx(®) test and to examine relevant dose/volume parameters as well as patient characteristics potentially influencing the neurological baseline status and subsequent outcome.
  
  
  METHODS
  The cohort consisted of 44 astrocytoma World Health Organization grade III/IV patients. The NeuroCogFx(®) test was carried out on patients during (N = 44) and after (N = 21) irradiation. The test examines verbal/figural/short-term/working memory, psychomotorical speed, selective attention and verbal speed. The results were compared with regular patient and treatment data with an emphasis on the dose applied to the hippocampus.
  
  
  RESULTS
  Overall there were only slight changes in the median test results when comparing the baseline to the follow-up tests. In the 'verbal memory test' lower percentile ranks were achieved in left-sided tumors compared to right-sided tumors (p = 0.034). Dexamethasone intake during radiotherapy was significantly correlated with the difference between the two test batteries. Concerning figural memory, a correlation was detected between decreased figural recognition and the radiation dose to the left hippocampus (p = 0.045).
  
  
  CONCLUSIONS
  We conclude that tumor infiltration of the hippocampus has an impact on neurocognitive function. However, treatment with radiotherapy seems to have less influence on cognitive outcome than expected.
authors.affiliation: Klinik und Poliklinik für Strahlentherapie und Radioonkologie, LMU Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany. raphael.bodensohn@googlemail.com.
authors.forename: Raphael
authors.initials: R
authors.lastname: Bodensohn
authors.affiliation: Klinik und Poliklinik für Strahlentherapie und Radioonkologie, LMU Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Corradini
authors.affiliation: Klinik und Poliklinik für Strahlentherapie und Radioonkologie, LMU Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Ute
authors.initials: U
authors.lastname: Ganswindt
authors.affiliation: Klinik und Poliklinik für Strahlentherapie und Radioonkologie, LMU Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Hofmaier
authors.affiliation: Neurochirurgische Klinik und Poliklinik, LMU Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Schnell
authors.affiliation: Klinik und Poliklinik für Strahlentherapie und Radioonkologie, LMU Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany.|German Cancer Consortium (DKTK), Munich, Germany.|German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Belka
authors.affiliation: Klinik und Poliklinik für Strahlentherapie und Radioonkologie, LMU Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany.|German Cancer Consortium (DKTK), Munich, Germany.|German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Niyazi
mesh_terms: D001254:Astrocytoma / Q000150:complications / Q000473:pathology* / Q000532:radiotherapy*; D001288:Attention; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology* / Q000532:radiotherapy*; D003071:Cognition; D005260:Female; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D008606:Mental Processes / Q000528:radiation effects; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011788:Quality of Life; D011879:Radiotherapy Dosage; D011930:Reaction Time
keywords: High-grade glioma; Hippocampal sparing; Hippocampus; Neurocognition; Radiation therapy