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Review
. 2024 Aug 21:16:1043-1052.
doi: 10.2147/CMAR.S441360. eCollection 2024.

Radiation-Induced Cognitive Decline: Challenges and Solutions

Parisa Shamsesfandabadi  1 , Arpeet Patel  2 , Yun Liang  1 , Matthew J Shepard  3 , Rodney E Wegner  1
Affiliations
Review

Radiation-Induced Cognitive Decline: Challenges and Solutions

Parisa Shamsesfandabadi et al. Cancer Manag Res. .

Abstract

Radiation therapy, a common treatment for central nervous system cancers, can negatively impact cognitive function, resulting in radiation-induced cognitive decline (RICD). RICD involves a decline in cognitive abilities such as memory and attention, likely due to damage to brain white matter, inflammation, and oxidative stress. The multifactorial nature of RICD poses challenges including different mechanisms of injury (neurogenesis, oxidative stress and neuroinflammation, dendritic structure alterations and vascular effects) and confounding factors like advanced age, and pre-existing conditions. Despite these challenges, several potential solutions exist. Neuroprotective agents like antioxidants can mitigate radiation damage, while cognitive rehabilitation techniques such as cognitive training and memory strategies improve cognitive function. Advanced imaging techniques like magnetic resonance imaging (MRI) help identify vulnerable brain areas, and proton therapy offers precise targeting of cancer cells, sparing healthy tissue. Multidisciplinary care teams are crucial for managing RICD's cognitive and psychological effects. Personalized medicine, using genetic and molecular data, can identify high-risk patients and tailor treatments accordingly. Emerging therapies, including stem cell therapy and regenerative medicine, offer hope for repairing or replacing damaged brain tissue. Addressing RICD is vital for cancer survivors, necessitating consideration of cognitive function and provision of appropriate support and resources for those experiencing cognitive decline.

Keywords: RICD; central nervous system cancers; cognitive decline; cognitive function; radiation therapy; radiation-induced cognitive decline.

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Conflict of interest statement

Dr Rodney Wegner reports grants from Elekta, during the conduct of the study. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Stem cell therapy for neurogenesis damage.
Figure 2
Figure 2
Anti-inflammatory agents for oxidative stress and neuroinflammation.
Figure 3
Figure 3
Memantine for dendritic structure alterations.
Figure 4
Figure 4
Cyclooxygenase-2 (COX-2) inhibitors, erythropoietin (EPO) for vascular effects.
See this image and copyright information in PMC

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