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Title: Incidence of Brain Atrophy and Decline in Mini-Mental State Examination Score After Whole-Brain Radiotherapy in Patients With Brain Metastases: A Prospective Study

Abstract

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 decreasemore » 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.« less

Authors:
 [1];  [1]; ; ; ; ;  [2];  [1];  [2]
  1. Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya (Japan)
  2. Chubu Radiation Oncology Group, Nagoya (Japan)
Publication Date:
OSTI Identifier:
21172471
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 72; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2008.02.054; PII: S0360-3016(08)00423-9; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ATROPHY; BRAIN; CARCINOMAS; CEREBROSPINAL FLUID; COMPUTERIZED TOMOGRAPHY; METASTASES; NERVOUS SYSTEM DISEASES; NMR IMAGING; PATIENTS; RADIOTHERAPY; SURGERY

Citation Formats

Shibamoto, Yuta, Chubu Radiation Oncology Group, Nagoya, Baba, Fumiya, Chubu Radiation Oncology Group, Nagoya, Oda, Kyota, Hayashi, Shinya, Kokubo, Masaki, Ishihara, Shun-Ichi, Itoh, Yoshiyuki, Ogino, Hiroyuki, Chubu Radiation Oncology Group, Nagoya, and Koizumi, Masahiko. Incidence of Brain Atrophy and Decline in Mini-Mental State Examination Score After Whole-Brain Radiotherapy in Patients With Brain Metastases: A Prospective Study. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2008.02.054.
Shibamoto, Yuta, Chubu Radiation Oncology Group, Nagoya, Baba, Fumiya, Chubu Radiation Oncology Group, Nagoya, Oda, Kyota, Hayashi, Shinya, Kokubo, Masaki, Ishihara, Shun-Ichi, Itoh, Yoshiyuki, Ogino, Hiroyuki, Chubu Radiation Oncology Group, Nagoya, & Koizumi, Masahiko. Incidence of Brain Atrophy and Decline in Mini-Mental State Examination Score After Whole-Brain Radiotherapy in Patients With Brain Metastases: A Prospective Study. United States. doi:10.1016/j.ijrobp.2008.02.054.
Shibamoto, Yuta, Chubu Radiation Oncology Group, Nagoya, Baba, Fumiya, Chubu Radiation Oncology Group, Nagoya, Oda, Kyota, Hayashi, Shinya, Kokubo, Masaki, Ishihara, Shun-Ichi, Itoh, Yoshiyuki, Ogino, Hiroyuki, Chubu Radiation Oncology Group, Nagoya, and Koizumi, Masahiko. Sat . "Incidence of Brain Atrophy and Decline in Mini-Mental State Examination Score After Whole-Brain Radiotherapy in Patients With Brain Metastases: A Prospective Study". United States. doi:10.1016/j.ijrobp.2008.02.054.
@article{osti_21172471,
title = {Incidence of Brain Atrophy and Decline in Mini-Mental State Examination Score After Whole-Brain Radiotherapy in Patients With Brain Metastases: A Prospective Study},
author = {Shibamoto, Yuta and Chubu Radiation Oncology Group, Nagoya and Baba, Fumiya and Chubu Radiation Oncology Group, Nagoya and Oda, Kyota and Hayashi, Shinya and Kokubo, Masaki and Ishihara, Shun-Ichi and Itoh, Yoshiyuki and Ogino, Hiroyuki and Chubu Radiation Oncology Group, Nagoya and Koizumi, Masahiko},
abstractNote = {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.},
doi = {10.1016/j.ijrobp.2008.02.054},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 72,
place = {United States},
year = {2008},
month = {11}
}