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Radiotherapy cognitive

J A Molad, D T Blumenthal, F Bokstein, M Findler, I Finkel, N M Bornstein, S Yust-Katz, E Auriel
Post-radiation leukoencephalopathy is characterized by cognitive impairment and white matter alternations on imaging. Cerebral small vessel disease (SVD) is one of several suggested etiologies. Cerebral microinfarction (CMI) is a recently described marker of SVD. We sought to examine the rate of CMI as a biomarker of ongoing ischemia among patients who underwent brain radiotherapy (RT). 110 patients treated with RT for primary or metastatic brain tumors were enrolled. A total of 685 brain MRI tests performed 1-108 months post-radiation were examined...
October 18, 2016: Journal of Neuro-oncology
Jaap C Reijneveld, Martin J B Taphoorn, Corneel Coens, Jacoline E C Bromberg, Warren P Mason, Khê Hoang-Xuan, Gail Ryan, Mohamed Ben Hassel, Roelien H Enting, Alba A Brandes, Antje Wick, Olivier Chinot, Michele Reni, Guy Kantor, Brian Thiessen, Martin Klein, Eugenie Verger, Christian Borchers, Peter Hau, Michael Back, Anja Smits, Vassilis Golfinopoulos, Thierry Gorlia, Andrew Bottomley, Roger Stupp, Brigitta G Baumert
BACKGROUND: Temozolomide chemotherapy versus radiotherapy in patients with a high-risk low-grade glioma has been shown to have no significant effect on progression-free survival. If these treatments have a different effect on health-related quality of life (HRQOL), it might affect the choice of therapy. We postulated that temozolomide compromises HRQOL and global cognitive functioning to a lesser extent than does radiotherapy. METHODS: We did a prospective, phase 3, randomised controlled trial at 78 medical centres and large hospitals in 19 countries...
September 26, 2016: Lancet Oncology
Galina Yordanova, Lee Martin, Farhad Afshar, Ian Sabin, Ghassan Alusi, Nicholas P Plowman, Fiona Riddoch, Jane Evanson, Matthew Matson, Ashley B Grossman, Scott A Akker, John P Monson, William M Drake, Martin O Savage, Helen L Storr
PURPOSE: Pediatric Cushing's disease (CD) is rare and there are limited data on the long-term outcomes. We assessed CD recurrence, body composition, pituitary function and psychiatric comorbidity in a cohort of pediatric CD patients. METHODS: Retrospective review of 21 CD patients, mean age at diagnosis 12.1 years (5.7-17.8), managed in our center between 1986 and 2010. Mean follow-up from definitive treatment was 10.6 years (2.9-27.2). RESULTS: Fifteen patients were in remission following transsphenoidal surgery (TSS) and 5 were in remission following TSS + external pituitary radiotherapy (RT)...
September 27, 2016: Pituitary
Anna C Furmaniak, Matthias Menig, Martina H Markes
BACKGROUND: A huge clinical research database on adjuvant cancer treatment has verified improvements in breast cancer outcomes such as recurrence and mortality rates. On the other hand, adjuvant and neoadjuvant therapy with chemotherapy and radiotherapy impacts on quality of life due to substantial short- and long-term side effects. A number of studies have evaluated the effect of exercise interventions on those side effects. This is an updated version of the original Cochrane review published in 2006...
September 21, 2016: Cochrane Database of Systematic Reviews
V Guimas, J Thariat, P Graff-Cailleau, P Boisselier, Y Pointreau, P Pommier, X Montbarbon, C Laude, S Racadot
Modern techniques such as intensity modulated radiation therapy (IMRT) have been proven to significantly decrease the dose delivered to the cochleovestibular apparatus, limiting consecutive toxicity especially for sensorineural hearing loss. However, recent data still report a 42% rate of radio-induced hypoacusia underscoring the need to protect the cochleovestibular apparatus. Due to the small size of the cochlea, a precise dose-volume analysis could not be performed, and recommendations only refer to the mean dose...
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Roberta Rudà, Federica Franchino, Riccardo Soffietti
PURPOSE OF REVIEW: The purpose of this review is to highlight the most recent advances in the management of brain metastases. RECENT FINDINGS: Role of local therapies (surgery and stereotactic radiosurgery), new approaches to minimize cognitive sequelae following whole-brain radiotherapy and advances in targeted therapies have been reviewed. SUMMARY: The implications for clinical trials and daily practice of the increasing use of stereotactic radiosurgery in multiple brain metastases and upfront targeted agents in asymptomatic brain metastases are discussed...
November 2016: Current Opinion in Oncology
Noora Tuovinen, Francesco de Pasquale, Massimo Caulo, Chiara Falletta Caravasso, Emilia Giudice, Roberto Miceli, Gianluca Ingrosso, Anne Laprie, Riccardo Santoni, Umberto Sabatini
BACKGROUND: The cognitive function of brain tumor patients is affected during the treatment. There is evidence that gliomas and surgery alter the functional brain connectivity but studies on the longitudinal effects are lacking. METHODS: We acquired longitudinal (pre- and post-radiotherapy) resting-state functional magnetic resonance imaging on three selected glioblastoma patients. These cases were selected to study three models: a lesion involving a functional hub within a central system, a lesion involving a peripheral node within a central system and a lesion involving a peripheral node of a non-central system...
2016: Radiation Oncology
Allison Lipitz-Snyderman, Camelia S Sima, Coral L Atoria, Elena B Elkin, Christopher Anderson, Victoria Blinder, Chiaojung Jillian Tsai, Katherine S Panageas, Peter B Bach
Importance: Interventions to address overuse of health care services may help reduce costs and improve care. Understanding physician-level variation and behavior patterns can inform such interventions. Objective: To assess patterns of physician ordering of services that tend to be overused in the treatment of patients with cancer. We hypothesized that physicians exhibit consistent behavior. Design, Setting, and Participants: Retrospective study of patients 66 years and older diagnosed with cancer between 2004 and 2011, using population-based Surveillance, Epidemiology, and End Results (SEER)-Medicare data to assess physician-level variation in 5 nonrecommended services...
October 1, 2016: JAMA Internal Medicine
I Latorzeff, D Antoni, S Gaudaire-Josset, L Feuvret, A Tallet-Richard, G Truc, G Noël
Radiotherapy for brain metastases has become more multifaceted. Indeed, with the improvement of the patient's life expectancy, side effects must be undeniably avoided and the retreatments or multiple treatments are common. The cognitive side effects should be warned and the most modern techniques of radiation therapy are used regularly to reach this goal. The new classifications of patients with brain metastases help guiding treatment more appropriately. Stereotactic radiotherapy has supplanted whole brain radiation therapy both for patients with metastases in place and for those who underwent surgery...
September 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Neha Dahiya, Anita S Acharya, Damodar Bachani, Dn Sharma, Subhash Gupta, Kp Haresh, Gk Rath
BACKGROUND: Cervical cancer is the most frequently diagnosed cancer among women in India. Understanding quality of life (QOL) in women undergoing chemoradiotherapy for cervical cancer will help in introducing interventions for better care and outcomes in these women. This study assessed QOL before and after chemo radiotherapy in cervical cancer patients. MATERIALS AND METHODS: This followup study covered sixtyseven newly diagnosed women with advanced cervical cancer (stages 2b to 4b)...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
Cecilia Follin, Eva Marie Erfurth, Aki Johansson, Jimmy Lätt, Pia C Sundgren, Kai Österberg, Gabriella Spulber, Peter Mannfolk, Isabella M Björkman-Burtscher
Cranial radiotherapy is a known risk factor for neurocognitive impairment in survivors of childhood acute lymphoblastic leukemia (ALL). Understanding the nature of cognitive dysfunction during adulthood in ALL survivors is important as it has an impact on major life situations. Thirty-eight (21 women) ALL survivors were investigated 34 years after diagnosis. Median-age was 38 (27-46) years. All were treated with a CRT dose of 24Gy and 11 years (3-13) of complete hormone supplementation. Comparisons were made to 29 matched controls...
November 2016: Psychoneuroendocrinology
Marie Lange, Natacha Heutte, Olivier Rigal, Sabine Noal, Jean-Emmanuel Kurtz, Christelle Lévy, Djelila Allouache, Chantal Rieux, Johan Lefel, Bénédicte Clarisse, Corinne Veyret, Philippe Barthélémy, Nadine Longato, Hélène Castel, Francis Eustache, Bénédicte Giffard, Florence Joly
BACKGROUND: The impact of chemotherapy on cognition among elderly patients has received little attention, although such patients are more prone to presenting with age-related cognitive deficits and/or cognitive decline during chemotherapy. The present study assessed the cognitive function in older adults treated for early-stage breast cancer (EBC). PATIENTS AND METHODS: The participants were newly diagnosed EBC patients aged ≥65 years without previous systemic treatment or neurological or psychiatric disease and matched healthy controls...
July 29, 2016: Oncologist
Gloria Roldan Urgoiti, Aynharan Sinnarajah, Seema Hussain, Desiree Hao
Delirium in patients with cancer is associated with poor outcomes, but reversible causes need to be ruled out. We report the case of a 59-year-old woman who was presented with behavioural and cognitive changes over 2 weeks. She was non-verbal and combative, requiring involuntary admission and declaration of incompetence to make healthcare treatment decisions. Infectious and metabolic investigations and initial brain imaging were unremarkable. She was diagnosed with limited-stage small cell lung cancer and a paraneoplastic neuropsychiatric syndrome...
July 28, 2016: BMJ Supportive & Palliative Care
Khairul Majumder, Sten Nilsson, Hemming Johansson, Anders Ullén, Bo Lennernäs, Mia Bergenmar, Yvonne Brandberg
PURPOSE: To prospectively study differences in health-related quality of life (HRQoL) in patients with localised/locally advanced prostate cancer (PC) treated with curative intended radiation therapy and randomised to androgen receptor inhibitor monotherapy treatment versus castration plus an androgen receptor inhibitor used continuously. Time to Prostate Specific Antigen (PSA) relapse, time to symptomatic metastasis and overall survival (OS) were also described for the two groups. PATIENTS AND METHODS: From 2005 to 2011, a total of 110 patients were randomised at a ratio of 1:1...
September 2016: European Journal of Cancer
Paul D Brown, Kurt Jaeckle, Karla V Ballman, Elana Farace, Jane H Cerhan, S Keith Anderson, Xiomara W Carrero, Fred G Barker, Richard Deming, Stuart H Burri, Cynthia Ménard, Caroline Chung, Volker W Stieber, Bruce E Pollock, Evanthia Galanis, Jan C Buckner, Anthony L Asher
IMPORTANCE: Whole brain radiotherapy (WBRT) significantly improves tumor control in the brain after stereotactic radiosurgery (SRS), yet because of its association with cognitive decline, its role in the treatment of patients with brain metastases remains controversial. OBJECTIVE: To determine whether there is less cognitive deterioration at 3 months after SRS alone vs SRS plus WBRT. DESIGN, SETTING, AND PARTICIPANTS: At 34 institutions in North America, patients with 1 to 3 brain metastases were randomized to receive SRS or SRS plus WBRT between February 2002 and December 2013...
July 26, 2016: JAMA: the Journal of the American Medical Association
Qiongmin Ma, Donglin Wu, Ling-Li Zeng, Hui Shen, Dewen Hu, Shijun Qiu
The study aims to investigate the radiation-induced brain functional alterations in nasopharyngeal carcinoma (NPC) patients who received radiotherapy (RT) using functional magnetic resonance imaging (fMRI) and statistic scale.The fMRI data of 35 NPC patients with RT and 24 demographically matched untreated NPC patients were acquired. Montreal Cognitive Assessment (MoCA) was also measured to evaluate their global cognition performance. Multivariate pattern analysis was performed to find the significantly altered functional connections between these 2 groups, while the linear correlation level was detected between the altered functional connections and the MoCA scores...
July 2016: Medicine (Baltimore)
Christopher H Chapman, Tong Zhu, Mohamad Nazem-Zadeh, Yebin Tao, Henry A Buchtel, Christina I Tsien, Theodore S Lawrence, Yue Cao
PURPOSE/OBJECTIVES: Radiation injury to parahippocampal cingulum white matter is associated with cognitive decline. Diffusion tensor imaging (DTI) detects micropathologic changes in white matter. Increased radial diffusion (RD) and decreased axial diffusion (AD) correspond to demyelination and axonal degeneration/gliosis respectively. We aimed to develop a predictive model for radiation-induced cognitive changes based upon DTI changes. MATERIALS/METHODS: Twenty-seven adults with benign or low-grade tumors received partial brain radiation therapy (RT) to a median dose of 54Gy...
August 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Nils D Arvold, Eudocia Q Lee, Minesh P Mehta, Kim Margolin, Brian M Alexander, Nancy U Lin, Carey K Anders, Riccardo Soffietti, D Ross Camidge, Michael A Vogelbaum, Ian F Dunn, Patrick Y Wen
The clinical management/understanding of brain metastases (BM) has changed substantially in the last 5 years, with key advances and clinical trials highlighted in this review. Several of these changes stem from improvements in systemic therapy, which have led to better systemic control and longer overall patient survival, associated with increased time at risk for developing BM. Development of systemic therapies capable of preventing BM and controlling both intracranial and extracranial disease once BM are diagnosed is paramount...
August 2016: Neuro-oncology
S Taylor, A Byrne, R Adams, J Turner, L Hanna, J Staffurth, D Farnell, S Sivell, A Nelson, J Green
AIMS: Although pelvic radiotherapy is an effective treatment for various malignancies, around half of patients develop significant gastrointestinal problems. These symptoms often remain undetected, despite the existence of effective treatments. This study developed and refined a simple screening tool to detect common gastrointestinal symptoms in outpatient clinics. These symptoms have a significant effect on quality of life. This tool will increase detection rates and so enable access to specialist gastroenterologists, which will in turn lead to improved symptom control and quality of life after treatment...
October 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
J Shahi, J R Wright, Z Gabos, A Swaminath
BACKGROUND: The management of small-cell lung cancer (sclc) with radiotherapy (rt) varies, with many treatment regimens having been described in the literature. We created a survey to assess patterns of practice and clinical decision-making in the management of sclc by Canadian radiation oncologists (ros). METHODS: A 35-item survey was sent by e-mail to Canadian ros. The questions investigated the role of rt, the dose and timing of rt, target delineation, and use of prophylactic cranial irradiation (pci) in limited-stage (ls) and extensive-stage (es) sclc...
June 2016: Current Oncology
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