Document Detail


Incidence of brain atrophy and decline in mini-mental state examination score after whole-brain radiotherapy in patients with brain metastases: a prospective study.
MedLine Citation:
PMID:  18495375     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the incidence of brain atrophy and dementia after whole-brain radiotherapy (WBRT) in patients with brain metastases not undergoing surgery. METHODS AND MATERIALS: Eligible patients underwent WBRT to 40 Gy in 20 fractions with or without a 10-Gy boost. Brain magnetic resonance imaging or computed tomography and Mini-Mental State Examination (MMSE) were performed before and soon after radiotherapy, every 3 months for 18 months, and every 6 months thereafter. Brain atrophy was evaluated by change in cerebrospinal fluid-cranial ratio (CCR), and the atrophy index was defined as postradiation CCR divided by preradiation CCR. RESULTS: Of 101 patients (median age, 62 years) entering the study, 92 completed WBRT, and 45, 25, and 10 patients were assessable at 6, 12, and 18 months, respectively. Mean atrophy index was 1.24 +/- 0.39 (SD) at 6 months and 1.32 +/- 0.40 at 12 months, and 18% and 28% of the patients had an increase in the atrophy index by 30% or greater, respectively. No apparent decrease in mean MMSE score was observed after WBRT. Individually, MMSE scores decreased by four or more points in 11% at 6 months, 12% at 12 months, and 0% at 18 months. However, about half the decrease in MMSE scores was associated with a decrease in performance status caused by systemic disease progression. CONCLUSIONS: Brain atrophy developed in up to 30% of patients, but it was not necessarily accompanied by MMSE score decrease. Dementia after WBRT unaccompanied by tumor recurrence was infrequent.
Authors:
Yuta Shibamoto; Fumiya Baba; Kyota Oda; Shinya Hayashi; Masaki Kokubo; Shun-Ichi Ishihara; Yoshiyuki Itoh; Hiroyuki Ogino; Masahiko Koizumi
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Publication Detail:
Type:  Journal Article     Date:  2008-05-19
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  72     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-28     Completed Date:  2008-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1168-73     Citation Subset:  IM    
Affiliation:
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. yshiba@med.nagoya-cu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrophy
Brain / pathology*,  radiation effects
Brain Neoplasms / epidemiology*,  radiotherapy
Comorbidity
Dementia / epidemiology*
Female
Humans
Incidence
Japan / epidemiology
Male
Middle Aged
Neoplasm Recurrence, Local / epidemiology*,  prevention & control
Risk Assessment / methods*
Risk Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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