50: Prospective Neurocognitive Functions of Patients Treated with Concurrent Nivolumab and Stereotactic Brain Radiosurgery for NSCLC and RCC Brain Metastases

Abstract OBJECTIVE To study whether the neurocognitive functions were affected by brain metastases in patients, and what are the potential risk factors. METHODS A total of 172 patients with brain metastases were retrospectively analyzed. Prior to radiotherapy of brain metastases, the neurocognitive functions were evaluated by a wide range of tests including MOCA, VFT, HVLT-R, TMT-A, TMT-B and TOL. Kappa test was used to analyze the consistency of physical examination and neurocognitive assessment results. The related factors were analyzed with univariate and multivariate analysis. RESULTS 53 out of 172 patients (30.8%) were identified with cognitive impairments by physical examination. The assessment with neurocognitive scales revealed that there were 148 cases of cognitive impairment (86.0%) and 24 cases of normal cognition (14.0%). Kappa=0.025, indicating that the difference between neurocognitive assessment results and physical examination was significant. The univariate analysis on the factors related to neurocognitive impairment revealed that the risk factors that may affect the neurocognitive functions included age, KPS, m-GPA score, RPA classification, whether the original tumor was under control, with or without brain metastases. After adjusting for education, the multivariate analysis showed that age≥45 years old, KPS≤70, RPA classification >2 and m-GPA score< 3 were independent risk factors for neurocognitive impairment. CONCLUSION Patients with brain metastases were found to have various degrees of neurocognitive impairment prior to radiotherapy. The neurocognitive functions of patients can be more precisely evaluated by a comprehensive scale assessment. Age, KPS, RPA classification and m-GPA score are the main factors associated with neurocognitive impairment.

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Tumor Cavity Stereotactic Radiosurgery for Resected Brain Metastases

Journal of Cancer and Tumor International ◽

10.9734/jcti/2020/v10i230123 ◽

2020 ◽

pp. 15-30

Author(s):

Yasemin Bolukbasi ◽

Ugur Selek ◽

Duygu Sezen ◽

Nulifer Kilic Durankus ◽

Eyub Yasar Akdemir ◽

...

Keyword(s):

Brain Metastases ◽

Stereotactic Radiosurgery ◽

Randomized Trials ◽

Time Frame ◽

Clinical Approach ◽

Evidence Based ◽

Neurocognitive Functions ◽

Intact Brain ◽

Postoperative Setting ◽

Short Time

Stereotactic radiosurgery (SRS) has been utilized broadly for brain metastases not only for intact ones but as well as of late for the postoperative cavity of metastases after surgery, due to the advantages of SRS to preserve neurocognitive functions, maintain local control and prescribe the treatment in a short time frame. Randomized trials have proven the safety and efficacy of cavity SRS compared to observation. As WBRT offers no survival advantage in comparison to SRS and frequent monitorization with brain MRIs for early salvage upon failure, there has been a revolution in clinical approach for patients with limited intact brain metastases to treat with SRS only and omit WBRT. Likewise, the postoperative cavity SRS for brain metastases has gained a growing reputation. In this review, we summarize the proof for evidence-based optimization in the postoperative setting of the surgically removed brain metastases.

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OTHR-11. TUMOR RELATED IMPAIRMENTS OF NEUROCOGNITIVE FUNCTIONS IN PATIENTS WITH BRAIN METASTASES

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz014.088 ◽

2019 ◽

Vol 1 (Supplement_1) ◽

pp. i20-i20

Author(s):

Junjie Zhen ◽

Shaoqun Li ◽

Lei Wen ◽

Zhangrui Peng ◽

Mingyao Lai ◽

...

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Brain Metastases ◽

Physical Examination ◽

Univariate Analysis ◽

Neurocognitive Impairment ◽

Neurocognitive Functions ◽

Neurocognitive Assessment ◽

Wide Range ◽

Assessment Results

Abstract OBJECTIVE: To study whether the neurocognitive functions were affected by brain metastases in patients, and what are the potential risk factors. METHODS: A total of 172 patients with brain metastases were retrospectively analyzed. Prior to radiotherapy of brain metastases, the neurocognitive function was evaluated by a wide range of tests including MOCA, VFT, HVLT-R, TMT-A, TMT-B and TOL. Kappa test was used to analyze the consistency of physical examination and neurocognitive assessment results. The related factors were analyzed with univariate and multivariate analysis. RESULTS: 53 out of 172 patients (30.8%) were identified with cognitive impairments by physical examination. The assessment with neurocognitive scales revealed that there were 148 cases of cognitive impairment (86.0%) and 24 cases of normal cognition (14.0%). Kappa=0.025, indicating that the difference between neurocognitive assessment results and physical examination was significant. The univariate analysis on the factors related to neurocognitive impairment revealed that the risk factors that may affect the neurocognitive functions included age, KPS, m-GPA score, RPA classification, whether the original tumor was under control, with or without brain metastases. After adjusting for education, the multivariate analysis showed that age≥45 years old, KPS≤70, RPA classification >2 and m-GPA score< 3 were independent risk factors for neurocognitive impairment. CONCLUSION: Patients with brain metastases were found to have various degrees of neurocognitive impairment prior to radiotherapy. The neurocognitive functions of patients can be more precisely evaluated by a comprehensive scale assessment. Age, KPS, RPA classification and m-GPA score are the main factors associated with neurocognitive impairment.

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Tumour related impairments of neurocognitive functions in patients with brain metastases

Annals of Oncology ◽

10.1093/annonc/mdz243.043 ◽

2019 ◽

Vol 30 ◽

pp. v157

Author(s):

L. Wen ◽

S. Li ◽

M. Lai ◽

J. Zhen

Keyword(s):

Brain Metastases ◽

Neurocognitive Functions

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Palliative treatment of brain metastases with gamma knife

Therapeutische Umschau ◽

10.1024/0040-5930.58.7.413 ◽

2001 ◽

Vol 58 (7) ◽

pp. 413-418 ◽

Cited By ~ 1

Author(s):

Jean Siegfried ◽

G. Wellis ◽

S. Scheib ◽

D. Haller ◽

A. M. Landolt ◽

...

Keyword(s):

Brain Metastases ◽

Scale Score ◽

Gamma Knife ◽

Palliative Treatment ◽

Rating Scale ◽

Psychische Belastung ◽

Performance Rating ◽

Wird Eine

Das Gamma Knife ist ein stereotaktisch-radiochirurgisches Gerät, das erlaubt, radiologisch scharf begrenzte Hirntumore (oder arteriovenöse Missbildungen) mit einem Durchmesser von maximal 3,5 cm und einem Volumen von höchstens 25 cm3 zu behandeln. Diese Methode ist eine echte Alternative zur klassischen Behandlung von Hirnmetastasen mit operativer Entfernung und/oder Ganzhirnbestrahlung. Die Vorteile dieser Technik sind klar: die Methode ist nicht invasiv, die Behandlung benötigt nur eine Sitzung mit einer kurzen Hospitalisation von höchstens zwei bis drei Tagen, die physische und psychische Belastung ist gering, der Kopf wird weder rasiert noch verliert der Patient durch die Behandlung seine Haare; für eine befriedigende Überlebenszeit wird eine gute Lebensqualität erreicht und im Kostenvergleich mit alternativen Methoden (Operation und/oder anschließender Ganzhirnbestrahlung) wirtschaftlich günstiger. Von September 1994 bis Dezember 2000 wurden am Gamma Knife Zentrum in Zürich 140 an Hirnmetastasen leidende Patienten mit dieser Methode behandelt. Mit einer Überlebenszeit von durchschnittlich 263 Tagen und einem Maximum von drei Jahren entsprechen unsere Resultate denjenigen der Literatur mit weltweit über 30000 behandelten Patienten. Günstige Prognosen sind ein Karnofsky Performance Rating Scale Score zwischen 70 und 100, kleine Volumina der Metastasen, kontrollierter Primärtumor und fehlende oder stabile extrakranielle Metastasen.

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