Cognitive Impairment Associated With Whole Brain Radiotherapy For Brain Metastases

Objective To investigate the change of cognitive function associated with whole brainradiotherapy for brain metastases after treatment.Methods The study was based on patients (n=41) of brain metastases who receivedwhole brain radiotherapy, and MMSE was used as a cognitive assessment tool.Cognitive assessments were taken for the patients the week before radiotherapy, oneweek after radiotherapy and monthly after that, until6months later, to observe overallcognitive changes. Andin which the change of cognitive function of the patients beforeand after treatment with and without neurological symptoms group (12cases per group)was observed.Results there was significant deference between Baseline MMSE score and the scoreone week after radiotherapy in the41patients (28.146±0.528vs27.585±0.290,p=0.006). In no-neurological symptoms group(n=12),cognitive decline waspredominant in the fourth month, but improved subsequently, baseline MMSE scoreand the MMSE score4months after radiotherapy was significantlydifferent(29.125,±0.579vs26.500±0.524, p<0.001).In Neurological symptoms groupwith baseline MMSE score≤26(n=12), cognitive increase was predominant in thefourth month, Baseline MMSE score and the MMSE score4months after radiotherapywas significantly different(25.000±0.524vs27.500±0.370，p=0.001).Conclusion Whole brain radiotherapy may contribute to the cognitive impairment. the damage was a slowly pathological process which was predominant4months afterradiotherapy,but recoveredslightlyafter that;There was a Single dissociation betweenNeurological symptoms group and no-neurological symptoms group.