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Neurocognitive effects of proton radiation therapy in adults with low-grade glioma

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Abstract

To understand neurocognitive effects of proton radiation therapy (PRT) in patients with low-grade glioma, we evaluated 20 patients who received this therapy prospectively and over 5 years with a comprehensive neuropsychological battery. 20 patients were evaluated at baseline and at yearly intervals for up to 5 years with a battery of neuropsychological measures that assessed intellectual, attention, executive, visuospatial and memory functions as well as mood and functional status. We evaluated change in cognitive functioning over time. We analyzed the relationship between cognitive performance and tumor location and also examined whether patients’ performance differed from that reported in a study of normative practice effects. Overall, patients exhibited stability in cognitive functioning. Tumor location played a role in performance; those with tumors in the left hemisphere versus in the right hemisphere were more impaired at baseline on verbal measures (p < .05). However, we found greater improvement in verbal memory over time in patients with left than with right hemisphere tumors (p < .05). Results of our study, the first to investigate, in depth, neurocognitive effects of PRT in adults with low-grade gliomas, are promising. We hypothesize that the conformal advantage of PRT may contribute to preservation of cognitive functioning, although larger sample sizes and a longer period of study are required. Our study also highlights the need to consider normative practice effects when studying neurocognitive functioning in response to treatment over time, and the need to utilize comprehensive neuropsychological batteries given our findings that differentiate patients with left and right hemisphere tumors.

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Acknowledgments

This research was previously presented at the Eastern Psychological Association. Boston, MA, March 2014, the 19th Annual Scientific Meeting of the Society for Neuro-Oncology, Miami, FL, November, 2014 and at the International Neuropsychological Society 43rd Annual Meeting, February 2015 Denver, CO. We thank Casey Evans, Ramya Rangamannar and Alexandra Laffer for their assistance with data analysis and figure preparation.

Funding

This study was supported by a Pappas Award in Brain Tumor Research sponsored by Massachusetts General Hospital and by the Federal Share of program income earned by Massachusetts General Hospital on Proton Therapy Research and Treatment Center (grant C06CA059267).

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Authors and Affiliations

  1. Department of Psychiatry and Neurology, Psychology Assessment Center, Massachusetts General Hospital, 1 Bowdoin Square, 7th Floor, Boston, MA, 02114, USA

    Janet Cohen Sherman

  2. Department of Psychiatry, Psychology Assessment Center, Massachusetts General Hospital, 1 Bowdoin Square, 7th Floor, Boston, MA, 02114, USA

    Mary K. Colvin & Sarah M. Mancuso

  3. Department of Neurology, Massachusetts General Hospital, 30 Fruit Street, Boston, MA, 02114, USA

    Tracy T. Batchelor

  4. Department of Radiation Oncology, Massachusetts General Hospital, 30 Fruit Street, Boston, MA, 02114, USA

    Kevin S. Oh, Jay S. Loeffler & Helen A. Shih

  5. Department of Medicine, Massachusetts General Hospital, 30 Fruit Street, Boston, MA, 02114, USA

    Beow Y. Yeap

Authors
  1. Janet Cohen Sherman
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  2. Mary K. Colvin
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  3. Sarah M. Mancuso
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  4. Tracy T. Batchelor
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  5. Kevin S. Oh
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  6. Jay S. Loeffler
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  8. Helen A. Shih
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Correspondence to Janet Cohen Sherman.

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Sherman, J.C., Colvin, M.K., Mancuso, S.M. et al. Neurocognitive effects of proton radiation therapy in adults with low-grade glioma. J Neurooncol 126, 157–164 (2016). https://doi.org/10.1007/s11060-015-1952-5

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  • DOI: https://doi.org/10.1007/s11060-015-1952-5

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