Central neurotoxicity of standard treatment in patients with newly-diagnosed high-grade glioma: a prospective longitudinal study
Following tumor resection, the majority of high-grade glioma (HGG) patients are treated with a combined modality regimen of radiotherapy and temozolomide. As a result of the tumor itself or as treatment-related neurotoxic side-effects, these patients may experience cognitive deficits. Additionally,...
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| Veröffentlicht in: | Journal of neuro-oncology 2014-01, Vol.116 (2), p.387-394 |
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| creator | Froklage, F. E. Oosterbaan, L. J. Sizoo, E. M. de Groot, M. Bosma, I. Sanchez, E. Douw, L. Heimans, J. J. Reijneveld, J. C. Lagerwaard, F. J. Buter, J. Uitdehaag, B. M. J. Klein, M. Postma, T. J. |
| description | Following tumor resection, the majority of high-grade glioma (HGG) patients are treated with a combined modality regimen of radiotherapy and temozolomide. As a result of the tumor itself or as treatment-related neurotoxic side-effects, these patients may experience cognitive deficits. Additionally, radiological abnormalities expressed as white matter hyperintensities (WMH) and cerebral atrophy (CA) can develop. In this study, these functional and morphological parameters are evaluated, and their relation is investigated. After surgery, HGG patients underwent chemo-irradiation for six weeks, followed by six cycles of temozolomide. Assessments were performed before chemo-irradiation, post-concomitantly, after the third and sixth adjuvant cycle, and 3 and 7 months after treatment. Degree of WMH and CA was scored on MRI. Patients’ neuropsychological performance was compared to healthy matched controls, yielding six cognitive domain z-scores. Development or progression of pre-existing WMH and CA during follow-up was observed in 36 and 45 % of the patients (
n
= 39) respectively. Cognitive functioning remained stable or improved in 70 % of the patients and deteriorated in 30 % of the patients (
n
= 33). Of the cognitive decliners, 80 % had tumor progression within 4 months thereafter. No clear association between cognitive functioning and WMH or CA was found. Central neurotoxic effects of combined modality treatment in HGG patients expressed by radiological abnormalities are encountered in approximately 40 % of patients. However, functional impact as indexed by cognitive functioning was found to be limited. Furthermore, development or progression of pre-existing WMH and CA does not consistently result in functional impairment as measured by cognitive tests. |
| doi_str_mv | 10.1007/s11060-013-1310-4 |
| format | Article |
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n
= 39) respectively. Cognitive functioning remained stable or improved in 70 % of the patients and deteriorated in 30 % of the patients (
n
= 33). Of the cognitive decliners, 80 % had tumor progression within 4 months thereafter. No clear association between cognitive functioning and WMH or CA was found. Central neurotoxic effects of combined modality treatment in HGG patients expressed by radiological abnormalities are encountered in approximately 40 % of patients. However, functional impact as indexed by cognitive functioning was found to be limited. Furthermore, development or progression of pre-existing WMH and CA does not consistently result in functional impairment as measured by cognitive tests.</description><identifier>ISSN: 0167-594X</identifier><identifier>EISSN: 1573-7373</identifier><identifier>DOI: 10.1007/s11060-013-1310-4</identifier><identifier>PMID: 24264531</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adjuvants ; Adolescent ; Adult ; Aged ; Antineoplastic Agents, Alkylating - adverse effects ; Atrophy - chemically induced ; Brain Neoplasms - drug therapy ; Brain Neoplasms - radiotherapy ; Cerebral Cortex - pathology ; Clinical Study ; Cognition Disorders - chemically induced ; Cognition Disorders - diagnosis ; Dacarbazine - adverse effects ; Dacarbazine - analogs & derivatives ; Female ; Glioma - drug therapy ; Glioma - radiotherapy ; Humans ; Kaplan-Meier Estimate ; Leukoencephalopathies - chemically induced ; Leukoencephalopathies - diagnosis ; Longitudinal Studies ; Magnetic Resonance Imaging ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neurology ; Neuropsychological Tests ; Oncology ; Young Adult</subject><ispartof>Journal of neuro-oncology, 2014-01, Vol.116 (2), p.387-394</ispartof><rights>Springer Science+Business Media New York 2013</rights><rights>Springer Science+Business Media New York 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-ba3ed6a7b50abffdd4d8ee76c92a4ec25076397a4c08bbc194bf0a42aa6847f13</citedby><cites>FETCH-LOGICAL-c438t-ba3ed6a7b50abffdd4d8ee76c92a4ec25076397a4c08bbc194bf0a42aa6847f13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11060-013-1310-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11060-013-1310-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24264531$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Froklage, F. E.</creatorcontrib><creatorcontrib>Oosterbaan, L. J.</creatorcontrib><creatorcontrib>Sizoo, E. M.</creatorcontrib><creatorcontrib>de Groot, M.</creatorcontrib><creatorcontrib>Bosma, I.</creatorcontrib><creatorcontrib>Sanchez, E.</creatorcontrib><creatorcontrib>Douw, L.</creatorcontrib><creatorcontrib>Heimans, J. J.</creatorcontrib><creatorcontrib>Reijneveld, J. C.</creatorcontrib><creatorcontrib>Lagerwaard, F. J.</creatorcontrib><creatorcontrib>Buter, J.</creatorcontrib><creatorcontrib>Uitdehaag, B. M. J.</creatorcontrib><creatorcontrib>Klein, M.</creatorcontrib><creatorcontrib>Postma, T. J.</creatorcontrib><title>Central neurotoxicity of standard treatment in patients with newly-diagnosed high-grade glioma: a prospective longitudinal study</title><title>Journal of neuro-oncology</title><addtitle>J Neurooncol</addtitle><addtitle>J Neurooncol</addtitle><description>Following tumor resection, the majority of high-grade glioma (HGG) patients are treated with a combined modality regimen of radiotherapy and temozolomide. As a result of the tumor itself or as treatment-related neurotoxic side-effects, these patients may experience cognitive deficits. Additionally, radiological abnormalities expressed as white matter hyperintensities (WMH) and cerebral atrophy (CA) can develop. In this study, these functional and morphological parameters are evaluated, and their relation is investigated. After surgery, HGG patients underwent chemo-irradiation for six weeks, followed by six cycles of temozolomide. Assessments were performed before chemo-irradiation, post-concomitantly, after the third and sixth adjuvant cycle, and 3 and 7 months after treatment. Degree of WMH and CA was scored on MRI. Patients’ neuropsychological performance was compared to healthy matched controls, yielding six cognitive domain z-scores. Development or progression of pre-existing WMH and CA during follow-up was observed in 36 and 45 % of the patients (
n
= 39) respectively. Cognitive functioning remained stable or improved in 70 % of the patients and deteriorated in 30 % of the patients (
n
= 33). Of the cognitive decliners, 80 % had tumor progression within 4 months thereafter. No clear association between cognitive functioning and WMH or CA was found. Central neurotoxic effects of combined modality treatment in HGG patients expressed by radiological abnormalities are encountered in approximately 40 % of patients. However, functional impact as indexed by cognitive functioning was found to be limited. Furthermore, development or progression of pre-existing WMH and CA does not consistently result in functional impairment as measured by cognitive tests.</description><subject>Adjuvants</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Agents, Alkylating - adverse effects</subject><subject>Atrophy - chemically induced</subject><subject>Brain Neoplasms - drug therapy</subject><subject>Brain Neoplasms - radiotherapy</subject><subject>Cerebral Cortex - pathology</subject><subject>Clinical Study</subject><subject>Cognition Disorders - chemically induced</subject><subject>Cognition Disorders - diagnosis</subject><subject>Dacarbazine - adverse effects</subject><subject>Dacarbazine - analogs & derivatives</subject><subject>Female</subject><subject>Glioma - drug therapy</subject><subject>Glioma - radiotherapy</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Leukoencephalopathies - chemically induced</subject><subject>Leukoencephalopathies - diagnosis</subject><subject>Longitudinal Studies</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Neuropsychological Tests</subject><subject>Oncology</subject><subject>Young Adult</subject><issn>0167-594X</issn><issn>1573-7373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUGLFDEQhYMo7rj6A7xIwIuXuEkn3el4k0HdhQUvLuwtVCfpnizdyZikXefmT98Ms4oInqqgvveqiofQa0bfM0rlRWaMdpRQxgnjjBLxBG1YKzmRXPKnaENZJ0mrxO0ZepHzHaVUSM6eo7NGNJ1oOdugX1sXSoIZB7emWOJPb3w54DjiXCBYSBaX5KAsFcM-4D0UX9uM733ZVdH9fCDWwxRidhbv_LQjUwLr8DT7uMAHDHifYt47U_wPh-cYJl9W60NdmWtzeImejTBn9-qxnqObz5--bS_J9dcvV9uP18QI3hcyAHe2Azm0FIZxtFbY3jnZGdWAcKZpqey4kiAM7YfBMCWGkYJoALpeyJHxc_Tu5FvP-b66XPTis3HzDMHFNWsmVNf3TCle0bf_oHdxTfXiIyVb3irVNJViJ8rU_3Jyo94nv0A6aEb1MR59ikfXePQxHi2q5s2j8zoszv5R_M6jAs0JyHUUJpf-Wv1f1wduLZ3V</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Froklage, F. 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E.</au><au>Oosterbaan, L. J.</au><au>Sizoo, E. M.</au><au>de Groot, M.</au><au>Bosma, I.</au><au>Sanchez, E.</au><au>Douw, L.</au><au>Heimans, J. J.</au><au>Reijneveld, J. C.</au><au>Lagerwaard, F. J.</au><au>Buter, J.</au><au>Uitdehaag, B. M. J.</au><au>Klein, M.</au><au>Postma, T. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Central neurotoxicity of standard treatment in patients with newly-diagnosed high-grade glioma: a prospective longitudinal study</atitle><jtitle>Journal of neuro-oncology</jtitle><stitle>J Neurooncol</stitle><addtitle>J Neurooncol</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>116</volume><issue>2</issue><spage>387</spage><epage>394</epage><pages>387-394</pages><issn>0167-594X</issn><eissn>1573-7373</eissn><abstract>Following tumor resection, the majority of high-grade glioma (HGG) patients are treated with a combined modality regimen of radiotherapy and temozolomide. As a result of the tumor itself or as treatment-related neurotoxic side-effects, these patients may experience cognitive deficits. Additionally, radiological abnormalities expressed as white matter hyperintensities (WMH) and cerebral atrophy (CA) can develop. In this study, these functional and morphological parameters are evaluated, and their relation is investigated. After surgery, HGG patients underwent chemo-irradiation for six weeks, followed by six cycles of temozolomide. Assessments were performed before chemo-irradiation, post-concomitantly, after the third and sixth adjuvant cycle, and 3 and 7 months after treatment. Degree of WMH and CA was scored on MRI. Patients’ neuropsychological performance was compared to healthy matched controls, yielding six cognitive domain z-scores. Development or progression of pre-existing WMH and CA during follow-up was observed in 36 and 45 % of the patients (
n
= 39) respectively. Cognitive functioning remained stable or improved in 70 % of the patients and deteriorated in 30 % of the patients (
n
= 33). Of the cognitive decliners, 80 % had tumor progression within 4 months thereafter. No clear association between cognitive functioning and WMH or CA was found. Central neurotoxic effects of combined modality treatment in HGG patients expressed by radiological abnormalities are encountered in approximately 40 % of patients. However, functional impact as indexed by cognitive functioning was found to be limited. Furthermore, development or progression of pre-existing WMH and CA does not consistently result in functional impairment as measured by cognitive tests.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>24264531</pmid><doi>10.1007/s11060-013-1310-4</doi><tpages>8</tpages></addata></record> |
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| subjects | Adjuvants Adolescent Adult Aged Antineoplastic Agents, Alkylating - adverse effects Atrophy - chemically induced Brain Neoplasms - drug therapy Brain Neoplasms - radiotherapy Cerebral Cortex - pathology Clinical Study Cognition Disorders - chemically induced Cognition Disorders - diagnosis Dacarbazine - adverse effects Dacarbazine - analogs & derivatives Female Glioma - drug therapy Glioma - radiotherapy Humans Kaplan-Meier Estimate Leukoencephalopathies - chemically induced Leukoencephalopathies - diagnosis Longitudinal Studies Magnetic Resonance Imaging Male Medicine Medicine & Public Health Middle Aged Neurology Neuropsychological Tests Oncology Young Adult |
| title | Central neurotoxicity of standard treatment in patients with newly-diagnosed high-grade glioma: a prospective longitudinal study |
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