TY - JOUR
T1 - Longitudinal brain changes associated with prophylactic cranial irradiation in lung cancer
AU - Simó, Marta
AU - Vaquero, Lucía
AU - Ripollés, Pablo
AU - Gurtubay-Antolin, Ane
AU - Jové, Josep
AU - Navarro, Arturo
AU - Cardenal, Felipe
AU - Bruna, Jordi
AU - Rodríguez-Fornells, Antoni
N1 - Funding Information:
This work was supported by Fundació Marató-TV3 (Acquired Spinal Cord and Brain Injuries Program [2012–2014], grant awarded to Dr. Rodríguez-Fornells) and the Catalan Government (Generalitat de Catalunya, grant 2009 SGR 93 to Dr. Rodríguez-Fornells). Dr. Simó is a recipient of a Juan Rodés research contract from the Carlos III National Health Institute (Spanish government)-European Social Fund (ESF).
Publisher Copyright:
© 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc.
PY - 2016
Y1 - 2016
N2 - Introduction: The toxic effects of prophylactic cranial irradiation (PCI) and platinum-based chemotherapy on cognition in the lung cancer population have not yet been well established. In the present study we examined the longitudinal neuropsychological and brain structural changes observed in patients with lung cancer who were undergoing these treatments. Methods: Twenty-two patients with small cell lung cancer (SCLC) who underwent platinum-based chemotherapy and PCI were compared with two control groups: an age- and education-matched group of healthy controls (n = 21) and a group of patients with non-SCLC (NSCLC, n = 13) who underwent platinum-based chemotherapy. All groups were evaluated using a neuropsychological battery and multimodal structural magnetic resonance imaging: T1-weighted and diffusion tensor imaging at baseline (before PCI for SCLC and chemotherapy for NSCLC) and at 3 months after treatment. T1 voxel-based morphometry and tract-based spatial statistics were used to analyze microstructural changes in gray matter (GM) and white matter (WM). The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core Questionnaire was also completed. Results: Patients with SCLC exhibited cognitive deterioration in verbal fluency over time. Structural magnetic resonance imaging showed decreases in GM at 3 months in the right subcortical regions, bilateral insular cortex, and superior temporal gyrus in patients with SCLC compared with both control groups. Additionally, patients with SCLC showed decreases in GMover time in the aforementioned regions plus in the right parahippocampal gyrus and hippocampus, together with changes in the WM microstructure of the entire corpus callosum. These changes had a limited impact on responses to the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core Questionnaire, however. Patients with NSCLC showed no cognitive or brain structural differences after chemotherapy. Conclusions: This longitudinal study documents moderate neuropsychological deficits together with notable brainspecific structural changes (in GM and WM) in patients with SCLC after chemotherapy and PCI, suggesting that chemotherapy and especially PCI are associated with the development of cognitive and structural brain toxic effects.
AB - Introduction: The toxic effects of prophylactic cranial irradiation (PCI) and platinum-based chemotherapy on cognition in the lung cancer population have not yet been well established. In the present study we examined the longitudinal neuropsychological and brain structural changes observed in patients with lung cancer who were undergoing these treatments. Methods: Twenty-two patients with small cell lung cancer (SCLC) who underwent platinum-based chemotherapy and PCI were compared with two control groups: an age- and education-matched group of healthy controls (n = 21) and a group of patients with non-SCLC (NSCLC, n = 13) who underwent platinum-based chemotherapy. All groups were evaluated using a neuropsychological battery and multimodal structural magnetic resonance imaging: T1-weighted and diffusion tensor imaging at baseline (before PCI for SCLC and chemotherapy for NSCLC) and at 3 months after treatment. T1 voxel-based morphometry and tract-based spatial statistics were used to analyze microstructural changes in gray matter (GM) and white matter (WM). The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core Questionnaire was also completed. Results: Patients with SCLC exhibited cognitive deterioration in verbal fluency over time. Structural magnetic resonance imaging showed decreases in GM at 3 months in the right subcortical regions, bilateral insular cortex, and superior temporal gyrus in patients with SCLC compared with both control groups. Additionally, patients with SCLC showed decreases in GMover time in the aforementioned regions plus in the right parahippocampal gyrus and hippocampus, together with changes in the WM microstructure of the entire corpus callosum. These changes had a limited impact on responses to the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core Questionnaire, however. Patients with NSCLC showed no cognitive or brain structural differences after chemotherapy. Conclusions: This longitudinal study documents moderate neuropsychological deficits together with notable brainspecific structural changes (in GM and WM) in patients with SCLC after chemotherapy and PCI, suggesting that chemotherapy and especially PCI are associated with the development of cognitive and structural brain toxic effects.
KW - Chemotherapy
KW - Cognition
KW - Prophylactic cranial irradiation
KW - Radiotherapy
KW - Small cell lung cancer
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U2 - 10.1016/j.jtho.2015.12.110
DO - 10.1016/j.jtho.2015.12.110
M3 - Article
C2 - 26804637
AN - SCOPUS:84962877299
SN - 1556-0864
VL - 11
SP - 475
EP - 486
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
IS - 4
ER -