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Published in: Journal of Neuro-Oncology 2/2018

01-11-2018 | Clinical Study

Neurocognitive evaluation of brain metastases patients treated with post-resection stereotactic radiosurgery: a prospective single arm clinical trial

Authors: Assaf Berger, Ido Strauss, Shlomit Ben Moshe, Benjamin W. Corn, Dror Limon, Nathan Shtraus, Tal Shahar, Andrew A. Kanner

Published in: Journal of Neuro-Oncology | Issue 2/2018

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Abstract

Purpose

Post-operative radiation therapy for brain metastases (BM) has become standard treatment. Concerns regarding the deleterious cognitive effects of Whole Brain Radiation Therapy spurred a trend to use focal therapies such as stereotactic radiosurgery (SRS). The purpose of this study was to prospectively evaluate the neuropsychological effects following post-resection SRS treatment since limited data exist in this context.

Methods

We conducted a prospective single arm cohort study of patients with 1–2 BM, who underwent resection of a single BM between May 2015 to December 2016. Patients were evaluated for cognitive functions (NeuroTrax computerized neuropsychological battery; Modiin, Israel) and quality of life (QOL; QLQ-30, QLQ-BN20) before and 3 months following post-resection SRS.

Results

Twelve out of 14 patients completed pre- and post-SRS neurocognitive assessments. Overall, we did not detect significant neurocognitive or QOL changes 3 months following SRS. In a subgroup analysis among patients younger than 60 years, median global cognitive score increased from a pre-treatment score of 88 (72–102) to 95 (79–108), 3 months following SRS treatment, p = 0.042; Wilcoxon paired non-parametric test. Immediate verbal memory and executive functions scores increased from 86 (72–98) to 98 (92–112) and 86 (60–101) to 100 (80–126), respectively, p = 0.043. No significant cognitive changes were discovered among patients at the age of 60 or older.

Conclusions

Post-resection radiosurgery has a safe neuro-cognitive profile and is associated with preservation of nearly all quality of life parameters. Patients younger than 60 years benefit most and may even regain some cognitive functions within a few months after treatment.
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Metadata
Title
Neurocognitive evaluation of brain metastases patients treated with post-resection stereotactic radiosurgery: a prospective single arm clinical trial
Authors
Assaf Berger
Ido Strauss
Shlomit Ben Moshe
Benjamin W. Corn
Dror Limon
Nathan Shtraus
Tal Shahar
Andrew A. Kanner
Publication date
01-11-2018
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 2/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-018-2954-x

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