Cognitive functioning and health-related quality of life in patients with newly diagnosed primary CNS lymphoma: a systematic review

Meulen, Matthijs van der; Dirven, Linda; Habets, Esther J. J.; Bent, Martin J. van den; Taphoorn, Martin J.B.; Bromberg, Jacoline E C

doi:10.1016/s1470-2045(18)30356-5

Cited by 35 publications

(20 citation statements)

References 63 publications

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“…However, late cognitive deficits have been demonstrated in glioma patients, years after radiation and Procarbazine, lomustine and vincristine chemotherapy [27]. In contrast, a systematic review in patients with primary central nervous system (CNS) lymphoma without previous surgery or radiotherapy suggested that cognition improved after induction chemotherapy compared with baseline, presumably also partly due to corticosteroids [28]. For patients with systemic cancer, even without CNS metastases, there is an emerging body of research demonstrating that chemotherapeutic agents may cause cognitive deficits both on the short and long term [29].…”

Section: Text Of Reviewmentioning

confidence: 99%

Treatment of cognitive deficits in brain tumour patients: current status and future directions

Coomans

Linden

Gehring

et al. 2019

Current Opinion in Oncology

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Purpose of reviewIncreased life expectancy in brain tumour patients had led to the need for strategies that preserve and improve cognitive functioning, as many patients suffer from cognitive deficits. The tumour itself, as well as antitumor treatment including surgery, radiotherapy and chemotherapy, supportive treatment and individual patient factors are associated with cognitive problems. Here, we review the recent literature on approaches that preserve and improve cognitive functioning, including pharmacological agents and rehabilitation programs.Recent findingsMinimizing cognitive dysfunction and improving cognitive functioning in brain tumour patients may be achieved both by preserving cognitive functioning during antitumor treatment, including techniques such as awake brain surgery, less invasive radiation therapies such as stereotactic radiotherapy and proton therapy, as well as with interventions including cognitive rehabilitation programmes. Novel rehabilitation programs including computer-based cognitive rehabilitation therapy (CRT) programmes that can be adjusted to the specific patient needs and can be administered at home are promising. Furthermore, personalized/precision medicine approaches to identify patients who are at risk for cognitive decline may facilitate effective treatment strategies in the future.SummaryCognitive functioning has gained greater awareness in the neuro-oncological community, and methods to preserve and improve cognitive functioning have been explored. Rehabilitation programmes for brain tumour patients should be further developed and referred to in clinical practice.

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Section: Text Of Reviewmentioning

confidence: 99%

Treatment of cognitive deficits in brain tumour patients: current status and future directions

Coomans

Linden

Gehring

et al. 2019

Current Opinion in Oncology

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“…However, brain excisional biopsy is still the gold standard for diagnosis. Nevertheless, brain biopsy is an invasive procedure carries the risk of complications such as intracranial hemorrhage and functional impairment [14,15]. The procedure may also be challenging because of the di culty in reaching the deep tumor sites [16].…”

Section: Systematic Review Registration Prospero Crd42020218143mentioning

confidence: 99%

Diagnostic Biomarkers in Cerebrospinal Fluid in Primary Central Nervous System Lymphoma: A Protocol for Systematic Review and Meta-Analysis

Zhou¹,

Yi²,

Chen³

et al. 2020

Preprint

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BackgroundPrimary central nervous system lymphoma (PCNSL) is a highly aggressive non-hodgkin’s lymphoma with unfavorable prognosis. Currently, the diagnosis of PCNSL relies on brain excisional biopsy, which is an invasive procedure, carries the risk of complications such as intracranial hemorrhage and functional impairment. Finding effective biomarkers will help us to diagnose PCNSL faster and safer.MethodsThis systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) 2015 guideline.We will search databases including PubMed, Cochrane Library, Medline, Web of Science, EMBASE and CNKI. The studies that demonstrated the diagnostic value of certain biomarkers in CSF for PCNSL will be included. For quantitative value, the standardized mean diffenence (SMD) and their 95% confidence intervals (CI) will be calculated. The outcomes are the mean difference of biomarker levels in CSF between PCNSL patients and controls.DiscussionIn this systematic review we will analyze the studies of the biomarkers in cerebrospinal fluid for diagnosis of PCNSL. This research can help us to identify the biomarkers with diagnostic value for PCNSL, making diagnosis of PCNSL easier, faster and safer.Systematic review registrationPROSPERO CRD42020218143.

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“…However, treatment of PCSNL may cause neurotoxicity and compromise health-related quality of life. Studies have suggested that patients treated with combined high-dose methotrexate chemotherapy and consolidation whole-brain radiotherapy (WBRT) in the treatment of PCNSL develop worse neurotoxicity and cognitive dysfunction than those treated with chemotherapy alone (8)(9)(10)(11)(12). Thus, consolidation WBRT is often withheld unless necessary, particularly in elderly patients (13).…”

Section: Introductionmentioning

confidence: 99%

“…Thus, consolidation WBRT is often withheld unless necessary, particularly in elderly patients (13). Conversely, cognition, as measured by mini-mental state examination (MMSE) scores, frequently improves following the successful treatment of PCNSL with chemotherapy with or without immunotherapy (rituximab) and remains stable on follow-up (10,(14)(15)(16). However, currently, no study has described the neurological prognosis of PCNSL patients with a very poor neurocognitive function at baseline.…”

Section: Introductionmentioning

confidence: 99%

Absence of meaningful neurocognitive recovery in comatose patients with primary central nervous system lymphoma despite an effective response to chemotherapy: Case reports

Lim

Chan

2021

Mol Clin Oncol

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Primary central nervous system lymphoma (PCNSL) is a rare type of non-Hodgkin's lymphoma that occurs in patients who are elderly and immunocompromised. The most common treatment for PCNSL is high-dose methotrexate-based chemotherapy. Studies have suggested that the radiological response to high-dose methotrexate-based chemotherapy is associated with improved neurocognitive ability that remains stable upon follow-up. However, no study involving patients with an extremely poor neurological status before chemotherapy initiation has been reported, and the neurological prognosis of this group of patients remains unknown. The current case study described 3 patients with PCNSL diagnosed via biopsy who had comatose neurological states due to disease progression prior to treatment. All patients were treated with high-dose methotrexate-based chemotherapy. However, although effective radiological responses to treatment were achieved, no meaningful neurological or cognitive recovery was documented. Patients with PCNSL exhibiting a baseline comatose state have a poor neurological prognosis even with an effective tumour response to chemotherapy. Therefore, rapid detection and prompt treatment are crucial in patients with this disease.

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Cognitive functioning and health-related quality of life in patients with newly diagnosed primary CNS lymphoma: a systematic review

Cited by 35 publications

References 63 publications

Treatment of cognitive deficits in brain tumour patients: current status and future directions

Treatment of cognitive deficits in brain tumour patients: current status and future directions

Diagnostic Biomarkers in Cerebrospinal Fluid in Primary Central Nervous System Lymphoma: A Protocol for Systematic Review and Meta-Analysis

Absence of meaningful neurocognitive recovery in comatose patients with primary central nervous system lymphoma despite an effective response to chemotherapy: Case reports

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