ASPO Abstracts
Cognitive Function Post-Brain Irradiation: Characterizing Better-Performing Brain Cancer Survivors
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research,
Conference Year: 2018
Abstract Body:
Although brain cancer and its treatment generally impacts cognitive functioning, there may be a subset of survivors who do not evidence significant cognitive impairment post- treatment. This exploratory study seeks to a) identify brain tumor survivors with relatively intact cognitive functioning post-brain irradiation for brain cancer treatment and b) compare these survivors to those with poorer cognitive functioning on demographic, clinical, and psychosocial factors. A cognitive battery assessing memory, attention, language, and executive function was administered to 198 adult brain tumor survivors who were six months post-brain irradiation as part of a Phase 3 clinical trial. Better- performing survivors were defined as scoring within 1.5 standard deviations of the mean on each cognitive task using age- and education-adjusted norms. Survivors scoring outside of this criteria were identified as the poorer-performing group. T-test and chi- square analyses were conducted. 24% (n=48) of our sample met criteria for the better- performing group. These survivors were more likely to be White (p=0.03) and reported higher income (p=0.04) than the poorer-performing group (n=150). Better-performing survivors were also less likely to receive whole-brain irradiation (WBI; p=0.046), and reported higher functional well-being (e.g. ability to work, p<0.001), fewer subjective cognitive problems (p<0.001) and less fatigue (p=0.002). No significant group differences were found for age, education, sex, time since diagnosis, tumor location, resection size, total brain volume, or depression. Our preliminary findings suggest that there is a sizeable subgroup of brain tumor survivors with relatively intact cognitive functioning after a full course of brain irradiation. Understanding how these survivors differ from those with poorer cognitive functioning may lead to uncovering contributors to cognitive resilience. Although pre-treatment cognitive assessments are needed, our results suggest that type of radiation therapy (WBI or focal irradiation) is a major clinical factor associated with cognitive performance and functional activity. More research is needed to explore how neurotoxic effects of WBI may be buffered in brain cancer survivors.
Keywords: Cancer, brain, irradiation, cognition, survivorship