| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Departments of Neurology (Drs. Correa, DeAngelis, and Abrey, and A. Glass) and Epidemiology and Biostatistics (W. Shi and Dr. Thaler), Memorial Sloan-Kettering Cancer Center, New York; and Department of Neurology and Neuroscience (Drs. Correa, DeAngelis, and Abrey), Weill Medical College of Cornell University, New York, NY.
Address correspondence and reprint requests to Dr. Denise D. Correa, ABPP-CN, Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021; e-mail: corread{at}mskcc.org
Background: The standard treatment for primary CNS lymphoma (PCNSL) involves high-dose methotrexate-based (MTX) chemotherapy and whole brain radiotherapy (WBRT). This combined regimen prolongs patient survival, but also carries a substantial risk for delayed neurotoxicity particularly in the elderly. However, cognitive outcome evaluations have not been included in most clinical trials.
Objective: To assess cognitive functioning and quality of life in PCNSL survivors treated either with WBRT ± MTX-based chemotherapy or chemotherapy alone.
Methods: Twenty-eight PCNSL patients in disease remission received a post-treatment baseline neuropsychological evaluation, and a subset of patients were available for an 8-month follow-up evaluation. Assessment of quality of life and extent of white matter disease on MRI were also performed.
Results: Patients displayed mild to moderate impairments across several cognitive domains. These were of sufficient severity to reduce quality of life in half of the patient sample. Comparisons according to treatment type revealed more pronounced cognitive impairment, particularly in the memory and attention/executive domains, among patients treated with WBRT ± chemotherapy. Extent of white matter disease correlated with attention/executive, memory, and language impairment.
Conclusions: PCNSL survivors treated with WBRT ± chemotherapy displayed more pronounced cognitive dysfunction than patients treated with MTX-based chemotherapy alone.
Received August 4, 2003. Accepted in final form October 31, 2003.
Presented in part at the 2002 annual meeting of the American Academy of Neurology and at the 2003 annual meeting of the International Neuropsychological Society.
This article has been cited by other articles:
|
|
 |
|
  L. Angelov, N. D. Doolittle, D. F. Kraemer, T. Siegal, G. H. Barnett, D. M. Peereboom, G. Stevens, J. McGregor, K. Jahnke, C. A. Lacy, et al. Blood-Brain Barrier Disruption and Intra-Arterial Methotrexate-Based Therapy for Newly Diagnosed Primary CNS Lymphoma: A Multi-Institutional Experience J. Clin. Oncol., July 20, 2009; 27(21): 3503 - 3509. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Sierra del Rio, A. Rousseau, C. Soussain, D. Ricard, and K. Hoang-Xuan Primary CNS Lymphoma in Immunocompetent Patients Oncologist, May 1, 2009; 14(5): 526 - 539. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Illerhaus, R. Marks, F. Muller, G. Ihorst, F. Feuerhake, M. Deckert, C. Ostertag, and J. Finke High-dose methotrexate combined with procarbazine and CCNU for primary CNS lymphoma in the elderly: results of a prospective pilot and phase II study Ann. Onc., February 1, 2009; 20(2): 319 - 325. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-J. Zhu, E. R. Gerstner, D. A. Engler, M. M. Mrugala, W. Nugent, K. Nierenberg, F. H. Hochberg, R. A. Betensky, and T. T. Batchelor High-dose methotrexate for elderly patients with primary CNS lymphoma Neuro-oncol, January 1, 2009; 11(2): 211 - 215. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. Naylor, C. Bull, M. K. L. Nilsson, C. Zhu, T. Bjork-Eriksson, P. S. Eriksson, K. Blomgren, and H. G. Kuhn From the Cover: Voluntary running rescues adult hippocampal neurogenesis after irradiation of the young mouse brain PNAS, September 23, 2008; 105(38): 14632 - 14637. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Correa, L Maron, H Harder, M Klein, C. Armstrong, P Calabrese, J. Bromberg, L. Abrey, T. Batchelor, and D Schiff Cognitive functions in primary central nervous system lymphoma: literature review and assessment guidelines Ann. Onc., July 1, 2007; 18(7): 1145 - 1151. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Fischer, E. Thiel, H.-A. Klasen, J. Birkmann, K. Jahnke, P. Martus, and A. Korfel Prospective trial on topotecan salvage therapy in primary CNS lymphoma Ann. Onc., July 1, 2006; 17(7): 1141 - 1145. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Batchelor and J. S. Loeffler Primary CNS Lymphoma J. Clin. Oncol., March 10, 2006; 24(8): 1281 - 1288. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. P. Omuro, L. S. Ben-Porat, K. S. Panageas, A. K. Kim, D. D. Correa, J. Yahalom, L. M. DeAngelis, and L. E. Abrey Delayed Neurotoxicity in Primary Central Nervous System Lymphoma Arch Neurol, October 1, 2005; 62(10): 1595 - 1600. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. E. Abrey, T. T. Batchelor, A. J.M. Ferreri, M. Gospodarowicz, E. J. Pulczynski, E. Zucca, J. R. Smith, A. Korfel, C. Soussain, L. M. DeAngelis, et al. Report of an International Workshop to Standardize Baseline Evaluation and Response Criteria for Primary CNS Lymphoma J. Clin. Oncol., August 1, 2005; 23(22): 5034 - 5043. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Fliessbach, C. Helmstaedter, H. Urbach, A. Althaus, H. Pels, M. Linnebank, A. Juergens, A. Glasmacher, I. G. Schmidt-Wolf, T. Klockgether, et al. Neuropsychological outcome after chemotherapy for primary CNS lymphoma: A prospective study Neurology, April 12, 2005; 64(7): 1184 - 1188. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. D. Correa and L. E. Abrey Imaging Neurotoxicity: Is a Picture Worth a Thousand Words? AJNR Am. J. Neuroradiol., February 1, 2005; 26(2): 205 - 206. [Full Text] [PDF]
|
|
|
|
|
|
E. A. Neuwelt, P. E. Guastadisegni, P. Varallyay, and N. D. Doolittle Imaging Changes and Cognitive Outcome in Primary CNS Lymphoma after Enhanced Chemotherapy Delivery AJNR Am. J. Neuroradiol., February 1, 2005; 26(2): 258 - 265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M.P. Omuro, L. M. DeAngelis, J. Yahalom, and L. E. Abrey Chemoradiotherapy for primary CNS lymphoma: An intent-to-treat analysis with complete follow-up Neurology, January 11, 2005; 64(1): 69 - 74. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Cognitive Dysfunction in Primary CNS Lymphoma Survivors Journal Watch Psychiatry, September 23, 2004; 2004(923): 10 - 10. [Full Text]
|
|
|
|
 |
|
 Cognitive Dysfunction in Primary CNS Lymphoma Survivors Journal Watch Neurology, August 6, 2004; 2004(806): 7 - 7. [Full Text]
|
|
|
|
|
|
B. P. O'Neill Neurocognitive outcomes in primary CNS lymphoma (PCNSL) Neurology, February 24, 2004; 62(4): 532 - 533. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
