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Published in: Journal of Neuro-Oncology 2/2012

01-06-2012 | Effects of Standard of Art Treatment

The impact of chemotherapy on cognitive outcomes in adults with primary brain tumors

Author: Lauren E. Abrey

Published in: Journal of Neuro-Oncology | Issue 2/2012

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Abstract

There is growing recognition that chemotherapy may have short and long term impact on cognitive function of cancer patients. However, the impact of chemotherapy on the cognition of adult patients with primary brain tumor has not been extensively studied. This article will review the evidence for both positive and negative impact of chemotherapy on cognitive function of adult brain tumor patients as well as potential confounding factors.
Literature
1.
go back to reference Janelsins MC, Kohli S, Mohile SG et al (2011) An update on cancer- and chemotherapy-related cognitive dysfunction: current status. Semin Oncol 38:431–438PubMedCrossRef Janelsins MC, Kohli S, Mohile SG et al (2011) An update on cancer- and chemotherapy-related cognitive dysfunction: current status. Semin Oncol 38:431–438PubMedCrossRef
2.
go back to reference Wefel JS, Vardy J, Ahles T, Schagen SB (2011) International cognition and cancer task force recommendations to harmonise studies of cognitive function in patients with cancer. Lancet Oncol 12:703–708 Wefel JS, Vardy J, Ahles T, Schagen SB (2011) International cognition and cancer task force recommendations to harmonise studies of cognitive function in patients with cancer. Lancet Oncol 12:703–708
3.
go back to reference Raffa RB, Tallarida RJ (2010) Effects on the visual system might contribute to some of the cognitive deficits of cancer chemotherapy-induced ‘chemo-fog’. J Clin Pharm Ther 35:249–255PubMedCrossRef Raffa RB, Tallarida RJ (2010) Effects on the visual system might contribute to some of the cognitive deficits of cancer chemotherapy-induced ‘chemo-fog’. J Clin Pharm Ther 35:249–255PubMedCrossRef
4.
go back to reference Dietrich J, Han R, Yang Y et al (2006) CNS progenitor cells and oligodendrocytes are targets of chemotherapeutic agents in vitro and vivo. J Biol 5:1–23CrossRef Dietrich J, Han R, Yang Y et al (2006) CNS progenitor cells and oligodendrocytes are targets of chemotherapeutic agents in vitro and vivo. J Biol 5:1–23CrossRef
5.
go back to reference Dietrich J, Monje M, Wefel J et al (2008) Clinical patterns and biological correlates of cognitive dysfunction associated with cancer therapy. Oncologist 13:1285–1295PubMedCrossRef Dietrich J, Monje M, Wefel J et al (2008) Clinical patterns and biological correlates of cognitive dysfunction associated with cancer therapy. Oncologist 13:1285–1295PubMedCrossRef
6.
go back to reference Saykin AJ, Ahles TA, McDonald BC (2003) Mechanisms of chemotherapy-induced cognitive disorders: neuropsychological, pathophysiological, and neuroimaging perspectives. Semin Clin Neuropsychiatry 8:201–216PubMedCrossRef Saykin AJ, Ahles TA, McDonald BC (2003) Mechanisms of chemotherapy-induced cognitive disorders: neuropsychological, pathophysiological, and neuroimaging perspectives. Semin Clin Neuropsychiatry 8:201–216PubMedCrossRef
7.
go back to reference Petzold A, Mondria T, Kuhle J et al (2010) Evidence for acute neurotoxicity after chemotherapy. Ann Neurol 68:806–815PubMedCrossRef Petzold A, Mondria T, Kuhle J et al (2010) Evidence for acute neurotoxicity after chemotherapy. Ann Neurol 68:806–815PubMedCrossRef
8.
go back to reference Lucas MR (2010) The impact of chemo brain on the patient with a high-grade glioma. Adv Exp Med Biol 678:21–25PubMedCrossRef Lucas MR (2010) The impact of chemo brain on the patient with a high-grade glioma. Adv Exp Med Biol 678:21–25PubMedCrossRef
9.
go back to reference Kaleita TA, Wellisch DK, Cloughesy TF et al (2004) Prediction of neurocognitive outcome in adult brain tumor patients. J Neurooncol 67:245–253PubMedCrossRef Kaleita TA, Wellisch DK, Cloughesy TF et al (2004) Prediction of neurocognitive outcome in adult brain tumor patients. J Neurooncol 67:245–253PubMedCrossRef
10.
11.
go back to reference Fietta P, Fietta P, Delsante G (2009) Central nervous system effects of natural and synthetic glucocorticoids. Psychiatry Clin Neurosci 63(5):613–622PubMedCrossRef Fietta P, Fietta P, Delsante G (2009) Central nervous system effects of natural and synthetic glucocorticoids. Psychiatry Clin Neurosci 63(5):613–622PubMedCrossRef
12.
13.
go back to reference Béhin A, Delattre JY (2004) Complications of radiation therapy on the brain and spinal cord. Semin Neurol 24(4):405–417PubMedCrossRef Béhin A, Delattre JY (2004) Complications of radiation therapy on the brain and spinal cord. Semin Neurol 24(4):405–417PubMedCrossRef
14.
go back to reference Correa DD, Maron L, Harder H et al (2007) Cognitive functions in primary central nervous system lymphoma: literature review and assessment guidelines. Ann Oncol 18:1145–1151PubMedCrossRef Correa DD, Maron L, Harder H et al (2007) Cognitive functions in primary central nervous system lymphoma: literature review and assessment guidelines. Ann Oncol 18:1145–1151PubMedCrossRef
15.
go back to reference Sandor V, Stark-Vancs V, Pearson D et al (1998) Phase II trial of chemotherapy alone for primary CNS and intraocular lymphoma. J Clin Oncol 16:3000–3006PubMed Sandor V, Stark-Vancs V, Pearson D et al (1998) Phase II trial of chemotherapy alone for primary CNS and intraocular lymphoma. J Clin Oncol 16:3000–3006PubMed
16.
go back to reference Correa DD, Anderson ND, Glass A et al (2003) Cognitive functions in primary central nervous system lymphoma patients treated with chemotherapy and stem cell transplantation: preliminary findings. Clin Adv Hematol Oncol 1:490PubMed Correa DD, Anderson ND, Glass A et al (2003) Cognitive functions in primary central nervous system lymphoma patients treated with chemotherapy and stem cell transplantation: preliminary findings. Clin Adv Hematol Oncol 1:490PubMed
17.
go back to reference Fliessbach K, Urbach H, Helmstaedter C et al (2003) Cognitive performance and magnetic resonance imaging findings after high-dose systemic and intraventricular chemotherapy for primary central nervous system lymphoma. Arch Neurol 60:563–568PubMedCrossRef Fliessbach K, Urbach H, Helmstaedter C et al (2003) Cognitive performance and magnetic resonance imaging findings after high-dose systemic and intraventricular chemotherapy for primary central nervous system lymphoma. Arch Neurol 60:563–568PubMedCrossRef
18.
go back to reference Fliessbach K, Helmstaedter C, Urbach H et al (2005) Neuropsychological outcome after chemotherapy for primary CNS lymphoma: a prospective study. Neurology 64:1184–1188PubMedCrossRef Fliessbach K, Helmstaedter C, Urbach H et al (2005) Neuropsychological outcome after chemotherapy for primary CNS lymphoma: a prospective study. Neurology 64:1184–1188PubMedCrossRef
19.
go back to reference Pels H, Schmidt-Wolf IGH, Glasmacher A et al (2003) Primary central nervous system lymphoma: results of a pilot study and phase II study of systemic and intraventricular chemotherapy with deferred radiotherapy. J Clin Oncol 21:4489–4495PubMedCrossRef Pels H, Schmidt-Wolf IGH, Glasmacher A et al (2003) Primary central nervous system lymphoma: results of a pilot study and phase II study of systemic and intraventricular chemotherapy with deferred radiotherapy. J Clin Oncol 21:4489–4495PubMedCrossRef
20.
go back to reference Schlegel U, Pels H, Glasmacher A et al (2001) Combined systemic and intraventricular chemotherapy in primary CNS lymphoma: a pilot study. J Neurol Neurosurg Psychiatr 71:118–122PubMedCrossRef Schlegel U, Pels H, Glasmacher A et al (2001) Combined systemic and intraventricular chemotherapy in primary CNS lymphoma: a pilot study. J Neurol Neurosurg Psychiatr 71:118–122PubMedCrossRef
21.
go back to reference Herrlinger U, Kuker W, Uhl M et al (2005) NOA-03 trial of high-dose methotrexate in primary central nervous system lymphoma: final report. Ann Neurol 57:843–847PubMedCrossRef Herrlinger U, Kuker W, Uhl M et al (2005) NOA-03 trial of high-dose methotrexate in primary central nervous system lymphoma: final report. Ann Neurol 57:843–847PubMedCrossRef
22.
go back to reference McAllister LD, Doolittle ND, Guastadisegni PE et al (2000) Cognitive outcomes and long-term follow-up results after enhanced chemotherapy delivery for primary central nervous system lymphoma. Neurosurgery 46:51–60PubMedCrossRef McAllister LD, Doolittle ND, Guastadisegni PE et al (2000) Cognitive outcomes and long-term follow-up results after enhanced chemotherapy delivery for primary central nervous system lymphoma. Neurosurgery 46:51–60PubMedCrossRef
23.
go back to reference Correa DD, DeAngelis LM, Shi W et al (2004) Cognitive functions in survivors of primary central nervous system lymphoma. Neurology 62:548–555PubMedCrossRef Correa DD, DeAngelis LM, Shi W et al (2004) Cognitive functions in survivors of primary central nervous system lymphoma. Neurology 62:548–555PubMedCrossRef
24.
go back to reference Wick W, Hartmann C, Engel C et al (2009) NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with procarbazine, lomustine, and vincristine or temozolomide. J Clin Oncol 27:5874–5880PubMedCrossRef Wick W, Hartmann C, Engel C et al (2009) NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with procarbazine, lomustine, and vincristine or temozolomide. J Clin Oncol 27:5874–5880PubMedCrossRef
25.
go back to reference Lassman AB, Iwamoto FM, Cloughesy TF et al (2011) International retrospective study of over 1000 adults with anaplastic oligodendroglial tumors. Neuro Oncol 13:649–659PubMedCrossRef Lassman AB, Iwamoto FM, Cloughesy TF et al (2011) International retrospective study of over 1000 adults with anaplastic oligodendroglial tumors. Neuro Oncol 13:649–659PubMedCrossRef
26.
go back to reference Abrey LE, Childs BH, Paleologos N et al (2006) High-dose chemotherapy with stem cell rescue as initial therapy for anaplastic oligodendroglioma: long-term follow-up. Neuro Oncol 8:183–188PubMedCrossRef Abrey LE, Childs BH, Paleologos N et al (2006) High-dose chemotherapy with stem cell rescue as initial therapy for anaplastic oligodendroglioma: long-term follow-up. Neuro Oncol 8:183–188PubMedCrossRef
27.
go back to reference A phase III intergroup study of radiotherapy versus temozolomide alone versus radiotherapy with concomitant and adjuvant temozolomide for patients with 1p/19q codeleted anaplastic glioma. ClinicalTrials.gov identifier: NCT00887146 A phase III intergroup study of radiotherapy versus temozolomide alone versus radiotherapy with concomitant and adjuvant temozolomide for patients with 1p/19q codeleted anaplastic glioma. ClinicalTrials.gov identifier: NCT00887146
28.
go back to reference Soffietti R, Baumert BG, Bello L (2010) European federation of neurological societies. Guidelines on management of low-grade gliomas: report of an EFNS-EANO task force. Eur J Neurol 17(9):1124–1133PubMedCrossRef Soffietti R, Baumert BG, Bello L (2010) European federation of neurological societies. Guidelines on management of low-grade gliomas: report of an EFNS-EANO task force. Eur J Neurol 17(9):1124–1133PubMedCrossRef
29.
go back to reference Mason WP, Krol GS, DeAngelis LM (1996) Low-grade oligodendroglioma responds to chemotherapy. Neurology 46(1):203–207PubMedCrossRef Mason WP, Krol GS, DeAngelis LM (1996) Low-grade oligodendroglioma responds to chemotherapy. Neurology 46(1):203–207PubMedCrossRef
30.
go back to reference Brada M, Viviers L, Abson C et al (2003) Phase II study of primary temozolomide chemotherapy in patients with WHO grade II gliomas. Ann Oncol 14(12):1715–1721PubMedCrossRef Brada M, Viviers L, Abson C et al (2003) Phase II study of primary temozolomide chemotherapy in patients with WHO grade II gliomas. Ann Oncol 14(12):1715–1721PubMedCrossRef
31.
go back to reference Kesari S, Schiff D, Drappatz J et al (2009) Phase II study of protracted daily temozolomide for low-grade gliomas in adults. Clin Cancer Res 15(1):330–337PubMedCrossRef Kesari S, Schiff D, Drappatz J et al (2009) Phase II study of protracted daily temozolomide for low-grade gliomas in adults. Clin Cancer Res 15(1):330–337PubMedCrossRef
32.
go back to reference Correa DD, Shi W, Thaler HT et al (2008) Longitudinal cognitive follow-up in low grade gliomas. J Neurooncol 86(3):321–327PubMedCrossRef Correa DD, Shi W, Thaler HT et al (2008) Longitudinal cognitive follow-up in low grade gliomas. J Neurooncol 86(3):321–327PubMedCrossRef
33.
go back to reference van den Bent MJ, Wefel JS, Schiff D et al (2011) Response assessment in neuro-oncology (a report of the RANO group): assessment of outcome in trials of diffuse low-grade gliomas. Lancet Oncol 12(6):583–593PubMedCrossRef van den Bent MJ, Wefel JS, Schiff D et al (2011) Response assessment in neuro-oncology (a report of the RANO group): assessment of outcome in trials of diffuse low-grade gliomas. Lancet Oncol 12(6):583–593PubMedCrossRef
34.
go back to reference A phase III randomized study of radiotherapy versus temozolomide in patients with low-grade gliomas. ClinicalTrials.gov identifier: NCT00182819 A phase III randomized study of radiotherapy versus temozolomide in patients with low-grade gliomas. ClinicalTrials.gov identifier: NCT00182819
35.
go back to reference A phase III study of radiation therapy with or without temozolomide for symptomatic or progressive low-grade gliomas. ClinicalTrials.gov identifier: NCT00978458 A phase III study of radiation therapy with or without temozolomide for symptomatic or progressive low-grade gliomas. ClinicalTrials.gov identifier: NCT00978458
36.
go back to reference van den Bent MJ, Carpentier AF, Brandes AA et al (2006) Adjuvant procarbazine, lomustine, and vincristine improves progression-free survival but not overall survival in newly diagnosed anaplastic oligodendrogliomas and oligoastrocytomas: a randomized European Organisation for Research and Treatment of Cancer phase III trial. J Clin Oncol 24:2715–2722PubMedCrossRef van den Bent MJ, Carpentier AF, Brandes AA et al (2006) Adjuvant procarbazine, lomustine, and vincristine improves progression-free survival but not overall survival in newly diagnosed anaplastic oligodendrogliomas and oligoastrocytomas: a randomized European Organisation for Research and Treatment of Cancer phase III trial. J Clin Oncol 24:2715–2722PubMedCrossRef
37.
go back to reference Cairncross G, Berkey B, Shaw E et al (2006) Phase III trial of chemotherapy plus radiotherapy compared with radiotherapy alone for pure and mixed anaplastic oligodendroglioma: intergroup radiation therapy oncology group trial 9402. J Clin Oncol 24:2707–2714PubMedCrossRef Cairncross G, Berkey B, Shaw E et al (2006) Phase III trial of chemotherapy plus radiotherapy compared with radiotherapy alone for pure and mixed anaplastic oligodendroglioma: intergroup radiation therapy oncology group trial 9402. J Clin Oncol 24:2707–2714PubMedCrossRef
38.
go back to reference Wang M, Cairncross G, Shaw E et al (2010) Cognition and quality of life after chemotherapy plus radiotherapy (RT) vs. RT for pure and mixed anaplastic oligodendrogliomas: radiation therapy oncology group trial 9402. Int J Radiat Oncol Biol Phys 77:662–669PubMedCrossRef Wang M, Cairncross G, Shaw E et al (2010) Cognition and quality of life after chemotherapy plus radiotherapy (RT) vs. RT for pure and mixed anaplastic oligodendrogliomas: radiation therapy oncology group trial 9402. Int J Radiat Oncol Biol Phys 77:662–669PubMedCrossRef
39.
go back to reference Taphoorn MJ, van den Bent MJ, Mauer ME et al (2007) Health-related quality of life in patients treated for anaplastic oligodendroglioma with adjuvant chemotherapy: results of a European Organisation for research and treatment of cancer randomized clinical trial. J Clin Oncol 25:5723–5730PubMedCrossRef Taphoorn MJ, van den Bent MJ, Mauer ME et al (2007) Health-related quality of life in patients treated for anaplastic oligodendroglioma with adjuvant chemotherapy: results of a European Organisation for research and treatment of cancer randomized clinical trial. J Clin Oncol 25:5723–5730PubMedCrossRef
40.
go back to reference Steinbach JP, Blaicher HP, Herrlinger U et al (2006) Surviving glioblastoma for more than 5 years: the patient’s perspective. Neurology 66:239–242PubMedCrossRef Steinbach JP, Blaicher HP, Herrlinger U et al (2006) Surviving glioblastoma for more than 5 years: the patient’s perspective. Neurology 66:239–242PubMedCrossRef
41.
go back to reference Hottinger AF, Yoon H, DeAngelis LM, Abrey LE (2009) Neurological outcome of long-term glioblastoma survivors. J Neurooncol 95:301–305PubMedCrossRef Hottinger AF, Yoon H, DeAngelis LM, Abrey LE (2009) Neurological outcome of long-term glioblastoma survivors. J Neurooncol 95:301–305PubMedCrossRef
42.
go back to reference Stupp R, Mason WP, van den Bent MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996PubMedCrossRef Stupp R, Mason WP, van den Bent MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996PubMedCrossRef
43.
go back to reference Stupp R, Hegi ME, Mason WP et al (2009) Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 10:459–466PubMedCrossRef Stupp R, Hegi ME, Mason WP et al (2009) Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 10:459–466PubMedCrossRef
44.
go back to reference Hilverda K, Bosma I, Heimans JJ et al (2010) Cognitive functioning in glioblastoma patients during radiotherapy and temozolomide treatment: initial findings. J Neurooncol 97:89–94PubMedCrossRef Hilverda K, Bosma I, Heimans JJ et al (2010) Cognitive functioning in glioblastoma patients during radiotherapy and temozolomide treatment: initial findings. J Neurooncol 97:89–94PubMedCrossRef
45.
go back to reference Scott JG, Suh JH, Elson P et al (2011) Aggressive treatment is appropriate for glioblastoma multiforme patients 70 years old or older: a retrospective review of 206 cases. Neuro Oncol 13:428–436PubMedCrossRef Scott JG, Suh JH, Elson P et al (2011) Aggressive treatment is appropriate for glioblastoma multiforme patients 70 years old or older: a retrospective review of 206 cases. Neuro Oncol 13:428–436PubMedCrossRef
46.
go back to reference Brandes AA, Franceschi E, Tosoni A et al (2009) Temozolomide concomitant and adjuvant to radiotherapy in elderly patients with glioblastoma: correlation with MGMT promoter methylation status. Cancer 115:3512–3518PubMedCrossRef Brandes AA, Franceschi E, Tosoni A et al (2009) Temozolomide concomitant and adjuvant to radiotherapy in elderly patients with glioblastoma: correlation with MGMT promoter methylation status. Cancer 115:3512–3518PubMedCrossRef
47.
go back to reference Minniti G, De Sanctis V, Muni R et al (2008) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma in elderly patients. J Neurooncol 88:97–103PubMedCrossRef Minniti G, De Sanctis V, Muni R et al (2008) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma in elderly patients. J Neurooncol 88:97–103PubMedCrossRef
48.
go back to reference Sijben AE, McIntyre JB, Roldán GB et al (2008) Toxicity from chemoradiotherapy in older patients with glioblastoma multiforme. J Neurooncol 89:97–103PubMedCrossRef Sijben AE, McIntyre JB, Roldán GB et al (2008) Toxicity from chemoradiotherapy in older patients with glioblastoma multiforme. J Neurooncol 89:97–103PubMedCrossRef
49.
go back to reference A randomized phase III study of temozolomide and short-course radiation versus short-course radiation alone in the treatment of newly diagnosed glioblastoma multiforme in elderly patients. Clinicaltrials.gov identifier: NCT00482677 A randomized phase III study of temozolomide and short-course radiation versus short-course radiation alone in the treatment of newly diagnosed glioblastoma multiforme in elderly patients. Clinicaltrials.gov identifier: NCT00482677
50.
go back to reference Gállego Pérez-Larraya J, Ducray F, Chinot O et al (2011) Temozolomide in elderly patients with newly diagnosed glioblastoma and poor performance status: an ANOCEF phase II trial. J Clin Oncol 29(22):3050–3055PubMedCrossRef Gállego Pérez-Larraya J, Ducray F, Chinot O et al (2011) Temozolomide in elderly patients with newly diagnosed glioblastoma and poor performance status: an ANOCEF phase II trial. J Clin Oncol 29(22):3050–3055PubMedCrossRef
51.
go back to reference Wefel JS, Cloughesy T, Zazzali JL et al (2011) Neurocognitive function in patients with recurrent glioblastoma treated with bevacizumab. Neuro Oncol 13:660–668PubMedCrossRef Wefel JS, Cloughesy T, Zazzali JL et al (2011) Neurocognitive function in patients with recurrent glioblastoma treated with bevacizumab. Neuro Oncol 13:660–668PubMedCrossRef
Metadata
Title
The impact of chemotherapy on cognitive outcomes in adults with primary brain tumors
Author
Lauren E. Abrey
Publication date
01-06-2012
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 2/2012
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-012-0807-6

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