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Evaluation of cognitive function in patients with limited small cell lung cancer prior to and shortly following prophylactic cranial irradiation

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  • Prophylactic cranial irradiation (PCI), hippocampal avoidance (HA) whole brain radiotherapy (WBRT) and stereotactic radiosurgery (SRS) in small cell lung cancer (SCLC): Where do we stand?

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    Citation Excerpt :

    The toxicity of PCI and WBRT is an ongoing area of concern. The potential risk of resultant neurocognitive decline and other side effects which may detrimentally impact quality of life (QoL) have been the focus of several trials.[8-10] In the PCI setting, the neurocognitive concern has led to reduced acceptance of PCI by clinicians and patients.[11]

  • Risk factors for neurocognitive decline in lung cancer patients treated with prophylactic cranial irradiation: A systematic review

    2020, Cancer Treatment Reviews
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    In the Arriagada’s trial, the 2-year cumulative incidence of neuropsychological changes was not significantly different between PCI and observation (8–54% versus 8–42%, P-values 0.19–0.97) [31]. In Komaki’s study, no significant differences between pre-PCI and post-PCI were noted on any of the tests (30.0–39.0 before PCI versus 28.3–38.4 after PCI, P-values 0.21–0.95) [33]. In Grosshans’ study, for patients without progression, it was also not significantly different (17.0 ± 13.4 before PCI versus 24.9 ± 20.1 after PCI, P = 0.08) [37].

  • Impact of Lung Cancer Treatment on Cognitive Functioning

    2020, Clinical Lung Cancer
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    In the 3 studies objectively assessing cognition in patients treated with chemotherapy, radiotherapy in combination with or simultaneous with PCI, conflicting results were described for executive functioning, ranging from a mild deterioration of 6% up to an improvement of 10%.12,13 However, 4 other studies specifically assessing the impact of PCI in patients (after prior treatment with chemotherapy, surgery, and/or thoracic radiotherapy) demonstrated a negative impact on memory (especially verbal, visual, and short-term memory) and attention, up to 3 months after PCI (Table 2).7,14,15,17 Two studies also described a decline in fluency after PCI, ranging from a minor decline (0.5%) to a significant deterioration (P = .03) at 3 months.7,14

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Presented at the 29th Annual Meeting of the American Society of Clinical Oncology, 15–18 May, 1993.

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