Details

Autor(en) / Beteiligte

• Chow, James C.H.
• Lee, Jack
• Lai, Maria M.P.
• Li, Sara
• Lau, Adelina M.C.
• Ng, Beni S.Y.
• Leung, Gigi G.G.
• Li, Sharon T.Y.
• Lui, Jeffrey C.F.
• Cheung, Ka Man
• Au, Kwok Hung
• Wong, Kam Hung
• Lau, Alexander Y.L.
• Zee, Benny C.Y

Titel

Multi-domain neurocognitive impairment following definitive intensity-modulated radiotherapy for nasopharyngeal cancer: A cross-sectional study

Ist Teil von

• Radiotherapy and oncology, 2024-04, Vol.193, p.110143-110143, Article 110143

Ort / Verlag

Ireland: Elsevier B.V

Erscheinungsjahr

2024

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• •Inadvertent radiation to the brain is common during definitive radiotherapy for NPC.•Post-IMRT neurocognitive impairment is prevalent and profound among NPC survivors.•Verbal memory, processing speed, executive function, and motor dexterity are predominantly impaired.•Radiation doses to the whole brain, temporal lobe, and hippocampus may be associated with neurocognitive impairment. Neurocognitive impairment from inadvertent brain irradiation is common following intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC). This study aimed to determine the prevalence, pattern, and radiation dose-toxicity relationship of this late complication. We undertook a cross-sectional study of 190 post-IMRT NPC survivors. Neurocognitive function was screened using the Montreal Cognitive Assessment-Hong Kong (HK-MoCA). Detailed assessments of eight distinct neurocognitive domains were conducted: intellectual capacity (WAIS-IV), attention span (Digit Span and Visual Spatial Span), visual memory (Visual Reproduction Span), verbal memory (Auditory Verbal Learning Test), processing speed (Color Trail Test), executive function (Stroop Test), motor dexterity (Grooved Pegboard Test) and language ability (Verbal Fluency Test). The mean percentiles and Z-scores were compared with normative population data. Associations between radiation dose and brain substructures were explored using multivariable logistic regression. The median post-IMRT interval was 7.0 years. The prevalence of impaired HK-MoCA was 25.3 % (48/190). Among the participants, 151 (79.4 %) exhibited impairments in at least one neurocognitive domain. The predominantly impaired domains included verbal memory (short-term: mean Z-score, −0.56, p < 0.001; long-term: mean Z-score, −0.70, p < 0.001), processing speed (basic: mean Z-score, −1.04, p < 0.001; advanced: mean Z-score, −0.38, p < 0.001), executive function (mean Z-score, −1.90, p < 0.001), and motor dexterity (dominant hand: mean Z-score, −0.97, p < 0.001). Radiation dose to the whole brain, hippocampus, and temporal lobe was associated with impairments in executive function, verbal memory, processing speed, and motor dexterity. Neurocognitive impairment is prevalent and profound in post-IMRT NPC survivors. Cognitive assessment and rehabilitation should be considered part of survivorship care.