Cognitive Effects of Chemotherapy and/or Cranial Irradiation in Adults

Abstract

There is evidence of cognitive impairment in adult tumor patients after chemotherapy similar to effects after cranial irradiation. Cognitive functioning below average before therapy may be due to paraneoplastic effects. More prospective studies with a long-term follow-up using standardized neuropsychometric testing, assessment of premorbid intelligence, and suited control groups are needed.

Craniospinal Radiotherapy in Adult Medulloblastoma

“…We have not modified the posterior fossa doses according to remaining residual tumor, as the literature is also blurred in this regard, lacking a trial whether a dose escalation to the residue is required or not [9,32,36]. Unfortunately, dose reduction prospective trials could not be carried out in an adult population due to the scarcity of patients.…”

Interventions for cognitive deficits in patients with a brain tumor: an update

“…Demyelination and microvascular injury, leading to necrosis [16,17], inflammation and impaired hippocampal neurogenesis, have been implicated in radiation-induced cognitive impairment [18][19][20]. Although the cognitive effects of chemo therapy are less clear, they might result from comparable mechanisms [21,22]. Antiepileptic drugs also have adverse effects [11,14,15,20,23].…”

Radiation Therapy in the Prevention of Brain Metastases

“…Cognitive functions mediated by white matter tract integrity appear to be most sensitive to radiation effects. For example, declines in memory, attention, psychomotor speed, and executive functioning have all been reported following WBRT [54,55]. These changes can range from mild to quite severe and debilitating, such as in the case of radiation-induced dementia.…”