The Cognitive Effects of Radiotherapy for Brain Metastases

Frontiers in Oncology

Jason P. Sheehan¹  Isabelle M. Germano²  Eric J. Lehrer³  Daniel R. Dickstein³  Brianna M. Jones³  Sheryl Green³  Jeffrey S. Wefel⁴  Daniel M. Trifiletti⁵  Nadia Laack⁶  Paul D. Brown⁶  Vinai Gondi⁷  Joshua D. Palmer⁸ 

[1] Department of Neurological Surgery, University of Virginia, Charlottesville, VA, United States;Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States;Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States;Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, United States;Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, United States;Department of Radiation Oncology, Mayo Clinic, Rochester, MN, United States;Department of Radiation Oncology, Northwestern Medicine Cancer Center Warrenville and Proton Center, Warrenville, IL, United States;Department of Radiation Oncology, Ohio State University Wexner Medical Center, Columbus, OH, United States;

关键词: brain metastases;    cognition;    radiation therapy;    radiosurgery;    whole brain radiation therapy;    neurosurgery;   

DOI  :  10.3389/fonc.2022.893264

来源: DOAJ

【 摘 要 】

Brain metastases are the most common intracranial neoplasm and are seen in upwards of 10-30% of patients with cancer. For decades, whole brain radiation therapy (WBRT) was the mainstay of treatment in these patients. While WBRT is associated with excellent rates of intracranial tumor control, studies have demonstrated a lack of survival benefit, and WBRT is associated with higher rates of cognitive deterioration and detrimental effects on quality of life. In recent years, strategies to mitigate this risk, such as the incorporation of memantine and hippocampal avoidance have been employed with improved results. Furthermore, stereotactic radiosurgery (SRS) has emerged as an appealing treatment option over the last decade in the management of brain metastases and is associated with superior cognitive preservation and quality of life when compared to WBRT. This review article evaluates the pathogenesis and impact of cranial irradiation on cognition in patients with brain metastases, as well as current and future risk mitigation techniques.

【 授权许可】

Unknown