Long-term neurocognitive function and quality of life after multimodal therapy in adult glioma patients: a prospective long-term follow-up

Pertz M, Schlömer S, Seidel C, Hentschel B, Löffler M, Schackert G, Krex D, Juratli T, Tonn JC, Schnell O, Vatter H, Simon M, Westphal M, Martens T, Sabel M, Bendszus M, Dörner N, Wick A, Fliessbach K, Hoppe C, Klingner M, Felsberg J, Reifenberger G, Gramatzki D, Weller M, Schlegel U (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Journal of Neuro-Oncology Springer Verlag (Germany)

DOI: 10.1007/s11060-023-04419-y

Abstract

Purpose: Multimodal therapies have significantly improved prognosis in glioma. However, in particular radiotherapy may induce long-term neurotoxicity compromising patients’ neurocognition and quality of life. The present prospective multicenter study aimed to evaluate associations of multimodal treatment with neurocognition with a particular focus on hippocampal irradiation. Methods: Seventy-one glioma patients (WHO grade 1–4) were serially evaluated with neurocognitive testing and quality of life questionnaires. Prior to (baseline) and following further treatment (median 7.1 years [range 4.6–11.0] after baseline) a standardized computerized neurocognitive test battery (NeuroCog FX) was applied to gauge psychomotor speed and inhibition, verbal short-term memory, working memory, verbal and non-verbal memory as well as verbal fluency. Mean ipsilateral hippocampal radiation dose was determined in a subgroup of 27 patients who received radiotherapy according to radiotherapy plans to evaluate its association with neurocognition. Results: Between baseline and follow-up mean performance in none of the cognitive domains significantly declined in any treatment modality (radiotherapy, chemotherapy, combined radio-chemotherapy, watchful-waiting), except for selective attention in patients receiving chemotherapy alone. Apart from one subtest (inhibition), mean ipsilateral hippocampal radiation dose > 50 Gy (Dmean) as compared to < 10 Gy showed no associations with long-term cognitive functioning. However, patients with Dmean < 10 Gy showed stable or improved performance in all cognitive domains, while patients with > 50 Gy numerically deteriorated in 4/8 domains. Conclusions: Multimodal glioma therapy seems to affect neurocognition less than generally assumed. Even patients with unilateral hippocampal irradiation with > 50 Gy showed no profound cognitive decline in this series.

Authors with CRIS profile

Oliver Schnell

Involved external institutions

Klinikum der Universität München DE Germany (DE) Universitätsklinikum Bonn DE Germany (DE) Universitätsklinikum Heidelberg DE Germany (DE) Ruhr-Universität Bochum (RUB) DE Germany (DE) Universitätsklinikum Knappschaftskrankenhaus Bochum DE Germany (DE) Universitätsklinikum Leipzig DE Germany (DE) Universität Leipzig DE Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden DE Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Heinrich-Heine-Universität Düsseldorf DE Germany (DE) Universitätsspital Zürich (USZ) CH Switzerland (CH)

How to cite

APA:

Pertz, M., Schlömer, S., Seidel, C., Hentschel, B., Löffler, M., Schackert, G.,... Schlegel, U. (2023). Long-term neurocognitive function and quality of life after multimodal therapy in adult glioma patients: a prospective long-term follow-up. Journal of Neuro-Oncology. https://doi.org/10.1007/s11060-023-04419-y

MLA:

Pertz, Milena, et al. "Long-term neurocognitive function and quality of life after multimodal therapy in adult glioma patients: a prospective long-term follow-up." Journal of Neuro-Oncology (2023).

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