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. 2022 Jul;158(3):341-348.
doi: 10.1007/s11060-022-04019-2. Epub 2022 Apr 29.

Cognitive function after concurrent temozolomide-based chemoradiation therapy in low-grade gliomas

Deborah Y Park  1 , Martin C Tom  2 , Yanwen Chen  3 , Surabhi Tewari  1 , Manmeet S Ahluwalia  2 , Jennifer S Yu  1   4 , Samuel T Chao  1   4   5 , John H Suh  1   4   5 , David M Peereboom  1   5 , Glen H J Stevens  1   5 , Gene H Barnett  1   5   6 , Lilyana Angelov  5 , Alireza Mohammadi  5 , Thomas Hogan  7 , Courtney Kissel  7 , Brittany Lapin  3 , Isabel Schuermeyer  8 , Michael W Parsons  9 , Richard Naugle  1   7 , Erin S Murphy  10   11   12
Affiliations

Cognitive function after concurrent temozolomide-based chemoradiation therapy in low-grade gliomas

Deborah Y Park et al. J Neurooncol. 2022 Jul.

Abstract

Purpose: We sought to evaluate the effects of concurrent temozolomide-based chemoradiation therapy on neurocognitive function in patients with low-grade glioma (LGG).

Materials/methods: We included adult patients with LGG who were treated postoperatively with radiotherapy (RT) with concurrent and adjuvant temozolomide (TMZ). Patients were evaluated with comprehensive psychometric tests at baseline (prior to RT + TMZ) and at various time intervals following RT + TMZ. Baseline cognitive performance was analyzed by sex, age, education history, history of seizures, IDH mutation status, and 1p/19q codeletion status. Changes in neurocognitive performance were evaluated over time.

Results: Thirty-seven LGG patients (mean age 43.6, 59.5% male) had baseline neurocognitive evaluation. Patients with an age > 40 years old at diagnosis and those with an education > 16 years demonstrated superior baseline verbal memory as assessed by HVLT. No other cognitive domains showed differences when stratified by the variables mentioned above. A total of 22 LGG patients had baseline and post RT + TMZ neurocognitive evaluation. Overall, patients showed no statistical difference between group mean test scores prior to and following RT + TMZ on all psychometric measures (with the exception of HVLT Discrimination).

Conclusion: Cognitive function remained stable following RT + TMZ in LGG patients evaluated prospectively up to 2 years. The anticipated analysis of RTOG 0424 will provide valuable neurocognitive outcomes specifically for high risk LGG patients treated with RT + TMZ.

Keywords: Chemoradiation; Cognitive function; Low grade glioma; Neurocognitive testing; Temozolomide.

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