RT Journal Article
SR Electronic
T1 Neuroanatomical target theory as a predictive model for radiation-induced cognitive decline
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 747
OP 753
DO 10.1212/WNL.0b013e318283bb0a
VO 80
IS 8
A1 Ann M. Peiffer
A1 C. Marc Leyrer
A1 Dana M. Greene-Schloesser
A1 Elaine Shing
A1 William T. Kearns
A1 William H. Hinson
A1 Stephen B. Tatter
A1 Edward H. Ip
A1 Stephen R. Rapp
A1 Mike E. Robbins
A1 Edward G. Shaw
A1 Michael D. Chan
YR 2013
UL http://n.neurology.org/content/80/8/747.abstract
AB Objective: In a retrospective review to assess neuroanatomical targets of radiation-induced cognitive decline, dose volume histogram (DVH) analyses of specific brain regions of interest (ROI) are correlated to neurocognitive performance in 57 primary brain tumor survivors.Methods: Neurocognitive assessment at baseline included Trail Making Tests A/B, a modified Rey-Osterreith Complex Figure, California or Hopkins Verbal Learning Test, Digit Span, and Controlled Oral Word Association. DVH analysis was performed for multiple neuroanatomical targets considered to be involved in cognition. The %v10 (percent of ROI receiving 10 Gy), %v40, and %v60 were calculated for each ROI. Factor analysis was used to estimate global cognition based on a summary of performance on individual cognitive tests. Stepwise regression was used to determine which dose volume predicted performance on global factors and individual neurocognitive tests for each ROI.Results: Regions that predicted global cognitive outcomes at doses <60 Gy included the corpus callosum, left frontal white matter, right temporal lobe, bilateral hippocampi, subventricular zone, and cerebellum. Regions of adult neurogenesis primarily predicted cognition at %v40 except for the right hippocampus which predicted at %v10. Regions that did not predict global cognitive outcomes at any dose include total brain volume, frontal pole, anterior cingulate, right frontal white matter, and the right precentral gyrus.Conclusions: Modeling of radiation-induced cognitive decline using neuroanatomical target theory appears to be feasible. A prospective trial is necessary to validate these data.CCOP=Community Clinical Oncology Program; COWA=Controlled Oral Word Association; CVLT=California Verbal Learning Test; DVH=dose volume histogram; NCI=National Cancer Institute; NTCP=normal tissue complication probability; ROI=region of interest; RTOG=Radiation Therapy Oncology Group; ROCF=Rey-Osterrieth Complex Figure; RT=radiotherapy; SVZ=subventricular zone; WBI=whole-brain irradiation