Cognitive functioning in glioblastoma patients during radiotherapy and temozolomide treatment: initial findings

J Neurooncol. 2010 Mar;97(1):89-94. doi: 10.1007/s11060-009-9993-2. Epub 2009 Aug 30.

Abstract

The aim of this study was to evaluate cognitive functioning in newly-diagnosed glioblastoma multiforme (GBM) patients during treatment with radiotherapy (RT) plus concomitant and adjuvant temozolomide (TMZ). Cognitive assessment took place following surgery, but prior to the start of RT (baseline), after 6 weeks of RT and concomitant TMZ (1st follow-up), and after three cycles of adjuvant TMZ (2nd follow-up). Standardized cognitive summary measures and delta scores for six cognitive domains were calculated at the individual level. Cognitive functioning of progression-free GBM patients was compared to that of matched healthy controls. Analyses were performed on a group of 13 GBM patients that were progression-free during follow-up. The results showed that the majority of patients had deficits in multiple cognitive domains at baseline. Between baseline and 1st follow-up, four patients improved in one cognitive domain, four patients deteriorated in one domain, one patient improved in one domain and deteriorated in another, and four patients remained stable in all six domains. Between 1st and 2nd follow-up, the majority of patients (11) remained stable in all six cognitive domains, whereas one patient declined in one domain, and one patient showed a deterioration in two domains. Overall, between baseline and 2nd follow-up, three patients improved in one cognitive domain, two patients deteriorated in two domains, one patient improved in one domain and deteriorated in another, and seven patients remained stable in all six cognitive domains. In conclusion, preceding treatment, the majority of GBM patients show clear-cut deficits in cognitive functioning. In the course of the first 6 months of their disease, however, progression-free GBM patients undergoing radiotherapy plus concomitant and adjuvant temozolomide treatment do not deteriorate in cognitive functioning.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Agents, Alkylating / adverse effects
  • Antineoplastic Agents, Alkylating / pharmacology*
  • Attention / drug effects
  • Attention / radiation effects
  • Brain Neoplasms / drug therapy
  • Brain Neoplasms / radiotherapy
  • Cognition Disorders / etiology*
  • Dacarbazine / adverse effects
  • Dacarbazine / analogs & derivatives*
  • Dacarbazine / pharmacology
  • Female
  • Follow-Up Studies
  • Glioblastoma / drug therapy
  • Glioblastoma / radiotherapy
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Memory / drug effects
  • Memory / physiology
  • Memory / radiation effects
  • Mental Processes / drug effects
  • Mental Processes / radiation effects
  • Middle Aged
  • Neuropsychological Tests
  • Psychomotor Performance / drug effects
  • Psychomotor Performance / radiation effects
  • Radiotherapy, Adjuvant / adverse effects*
  • Temozolomide
  • Verbal Learning / drug effects
  • Verbal Learning / radiation effects

Substances

  • Antineoplastic Agents, Alkylating
  • Dacarbazine
  • Temozolomide