The effect of radiation dose to the brain on early self-reported cognitive function in brain and head-and-neck cancer patients
Purpose: Assess cognitive changes after radiotherapy (RT) in brain and head-and-neck (HN) cancer patients using patient-reported outcome measures (PROMs) and evaluate a dose–effect relationship for brain structures. Materials and methods: Primary brain and HN cancer patients treated with RT between...
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| Format: | Article |
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Elsevier
2025-05-01
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| Series: | Clinical and Translational Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630825000199 |
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| author | Femke Vaassen David Hofstede Catharina M.L. Zegers Jeanette B. Dijkstra Ann Hoeben Monique H.M.E. Anten Ruud M.A. Houben Frank Hoebers Inge Compter Wouter van Elmpt Daniëlle B.P. Eekers |
| author_facet | Femke Vaassen David Hofstede Catharina M.L. Zegers Jeanette B. Dijkstra Ann Hoeben Monique H.M.E. Anten Ruud M.A. Houben Frank Hoebers Inge Compter Wouter van Elmpt Daniëlle B.P. Eekers |
| author_sort | Femke Vaassen |
| collection | DOAJ |
| description | Purpose: Assess cognitive changes after radiotherapy (RT) in brain and head-and-neck (HN) cancer patients using patient-reported outcome measures (PROMs) and evaluate a dose–effect relationship for brain structures. Materials and methods: Primary brain and HN cancer patients treated with RT between 2012–2021 were included. Patient characteristics, clinical parameters, and PROMs at baseline and 1-year follow-up were collected. Cognitive functioning (CF) from the EORTC QLQ-C30, communication deficit (CD) from the QLQ-BN20, and one cognition-related questions from the EQ6D questionnaire were used, the latter two only for brain patients. Missing data were imputed and the four-point scale scores were transformed to a 100-point scale. Change in scores from baseline to 1-year were categorized into improvement/constant or deterioration. Organs-at-risk (OARs) were contoured either clinically or retrospectively using autocontouring and dose to the OARs were calculated. Results: A total of 110 brain and 356 HN cancer patients were included. Median age was 56 (brain) and 67.5 (HN) years. Baseline and 1-year CF was significantly lower for brain patients (p < 0.001). Univariate analysis for ΔCF showed that age at start RT ≤ 65 years, receiving chemotherapy, higher CF Baseline score, brain mean dose > 3 Gy, and multiple dose levels to left and right hippocampus were statistically associated with cognitive deterioration. Multivariate analysis for ΔCF identified age at RT ≤ 65 years, higher CF Baseline score, and brain mean dose > 3 Gy as significant predictors. Conclusion: This study identified risk factors for subjective cognitive decline and suggests that patients’ self-perceived cognitive deterioration may be related to age, CF baseline score and brain radiation dose above 3 Gy. |
| format | Article |
| id | doaj-art-22ec86465e1647ecbd30d7c078e33ea2 |
| institution | DOAJ |
| issn | 2405-6308 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj-art-22ec86465e1647ecbd30d7c078e33ea22025-08-20T03:12:38ZengElsevierClinical and Translational Radiation Oncology2405-63082025-05-015210092910.1016/j.ctro.2025.100929The effect of radiation dose to the brain on early self-reported cognitive function in brain and head-and-neck cancer patientsFemke Vaassen0David Hofstede1Catharina M.L. Zegers2Jeanette B. Dijkstra3Ann Hoeben4Monique H.M.E. Anten5Ruud M.A. Houben6Frank Hoebers7Inge Compter8Wouter van Elmpt9Daniëlle B.P. Eekers10Department of Radiation Oncology (Maastro) GROW Research Institute for Oncology and Reproduction Maastricht University Medical Centre+ Maastricht the Netherlands; Corresponding author at: Postbox 3035, 6202 NA Maastricht, the Netherlands.Department of Radiation Oncology (Maastro) GROW Research Institute for Oncology and Reproduction Maastricht University Medical Centre+ Maastricht the NetherlandsDepartment of Radiation Oncology (Maastro) GROW Research Institute for Oncology and Reproduction Maastricht University Medical Centre+ Maastricht the NetherlandsDepartment of Medical Psychology Maastricht University Medical Center+ Maastricht the NetherlandsDepartment of Medical Oncology GROW Research Institute for Oncology and Reproduction Maastricht University Medical Centre+ Maastricht the NetherlandsDepartment of Neurology Maastricht University Medical Centre+ Maastricht the NetherlandsDepartment of Radiation Oncology (Maastro) GROW Research Institute for Oncology and Reproduction Maastricht University Medical Centre+ Maastricht the NetherlandsDepartment of Radiation Oncology (Maastro) GROW Research Institute for Oncology and Reproduction Maastricht University Medical Centre+ Maastricht the NetherlandsDepartment of Radiation Oncology (Maastro) GROW Research Institute for Oncology and Reproduction Maastricht University Medical Centre+ Maastricht the NetherlandsDepartment of Radiation Oncology (Maastro) GROW Research Institute for Oncology and Reproduction Maastricht University Medical Centre+ Maastricht the NetherlandsDepartment of Radiation Oncology (Maastro) GROW Research Institute for Oncology and Reproduction Maastricht University Medical Centre+ Maastricht the NetherlandsPurpose: Assess cognitive changes after radiotherapy (RT) in brain and head-and-neck (HN) cancer patients using patient-reported outcome measures (PROMs) and evaluate a dose–effect relationship for brain structures. Materials and methods: Primary brain and HN cancer patients treated with RT between 2012–2021 were included. Patient characteristics, clinical parameters, and PROMs at baseline and 1-year follow-up were collected. Cognitive functioning (CF) from the EORTC QLQ-C30, communication deficit (CD) from the QLQ-BN20, and one cognition-related questions from the EQ6D questionnaire were used, the latter two only for brain patients. Missing data were imputed and the four-point scale scores were transformed to a 100-point scale. Change in scores from baseline to 1-year were categorized into improvement/constant or deterioration. Organs-at-risk (OARs) were contoured either clinically or retrospectively using autocontouring and dose to the OARs were calculated. Results: A total of 110 brain and 356 HN cancer patients were included. Median age was 56 (brain) and 67.5 (HN) years. Baseline and 1-year CF was significantly lower for brain patients (p < 0.001). Univariate analysis for ΔCF showed that age at start RT ≤ 65 years, receiving chemotherapy, higher CF Baseline score, brain mean dose > 3 Gy, and multiple dose levels to left and right hippocampus were statistically associated with cognitive deterioration. Multivariate analysis for ΔCF identified age at RT ≤ 65 years, higher CF Baseline score, and brain mean dose > 3 Gy as significant predictors. Conclusion: This study identified risk factors for subjective cognitive decline and suggests that patients’ self-perceived cognitive deterioration may be related to age, CF baseline score and brain radiation dose above 3 Gy.http://www.sciencedirect.com/science/article/pii/S2405630825000199RadiotherapyCognitive functioningCognitive declinePatients-reported outcome measuresQuality of lifeRadiation dose |
| spellingShingle | Femke Vaassen David Hofstede Catharina M.L. Zegers Jeanette B. Dijkstra Ann Hoeben Monique H.M.E. Anten Ruud M.A. Houben Frank Hoebers Inge Compter Wouter van Elmpt Daniëlle B.P. Eekers The effect of radiation dose to the brain on early self-reported cognitive function in brain and head-and-neck cancer patients Clinical and Translational Radiation Oncology Radiotherapy Cognitive functioning Cognitive decline Patients-reported outcome measures Quality of life Radiation dose |
| title | The effect of radiation dose to the brain on early self-reported cognitive function in brain and head-and-neck cancer patients |
| title_full | The effect of radiation dose to the brain on early self-reported cognitive function in brain and head-and-neck cancer patients |
| title_fullStr | The effect of radiation dose to the brain on early self-reported cognitive function in brain and head-and-neck cancer patients |
| title_full_unstemmed | The effect of radiation dose to the brain on early self-reported cognitive function in brain and head-and-neck cancer patients |
| title_short | The effect of radiation dose to the brain on early self-reported cognitive function in brain and head-and-neck cancer patients |
| title_sort | effect of radiation dose to the brain on early self reported cognitive function in brain and head and neck cancer patients |
| topic | Radiotherapy Cognitive functioning Cognitive decline Patients-reported outcome measures Quality of life Radiation dose |
| url | http://www.sciencedirect.com/science/article/pii/S2405630825000199 |
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