Little To No Neurocognitive Changes In Patients With Brain Metastases Treated With Gamma Knife RadiosurgeryKeywords: gamma knife, outcome, brain metastasis, memory, cancerInteractive Manuscript
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What is the background behind your study?
Whole brain radiotherapy has been shown to cause neurocognitive decline in patients with brain metastases.
What is the purpose of your study?
There has not yet been a natural history study of neurocognitive change in a population of patients treated only with brain metastases.
Describe your patient group.
. 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.
Describe what you did.
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
Describe your main findings.
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).
Describe the main limitation of this study.
This is a retrospective study.
Describe your main conclusion.
There were no significant declines in any of the neurocognitive areas assessed using a repeated measures analysis of variance.
Describe the importance of your findings and how they can be used by others.
There is evidence that at least within the average lifespan of a patient with brain metastasis neurocognition is stable following radiosurgery.
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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