Little To No Neurocognitive Changes In Patients With Brain Metastases Treated With Gamma Knife Radiosurgery

Keywords: gamma knife, outcome, brain metastasis, memory, cancer

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     Whole brain radiotherapy has been shown to cause neurocognitive decline in patients with brain metastases.
     There has not yet been a natural history study of neurocognitive change in a population of patients treated only with brain metastases.
     . 32 patients were enrolled. 53% men. 100% Caucasian. Mean education 1 year of college. Mean age 61.6 years (range 33-87). Seen between October 2006 and June 2009 but 50% have at least two years of follow-up. Median survival is 5 months.
     Patients with 1-5 brain metastases were given a brief neuropsychological evaluation at baseline and every three months following radiosurgery treatment. Patients stayed on study until they received whole brain radiation or died. Patients were given measures of visual attention, executive function, verbal fluency, memory, and fine motor control
     The only trends toward significance was in Trails B, a test of executive function, which trended towards improvement at 3 months post-radiosurgery (p=.06), and fine motor skills in the dominant hand, which trended toward worsening (p=.06). 
     This is a retrospective study.
      There were no significant declines in any of the neurocognitive areas assessed using a repeated measures analysis of variance.
     There is evidence that at least within the average lifespan of a patient with brain metastasis neurocognition is stable following radiosurgery.


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