Neurocognitive functioning and health-related quality of life in adult medulloblastoma patients: long-term outcomes of the NOA-07 study.
Brain tumor
Cognition
Medulloblastoma
Patient-reported outcome
Quality of life
Toxicity
Journal
Journal of neuro-oncology
ISSN: 1573-7373
Titre abrégé: J Neurooncol
Pays: United States
ID NLM: 8309335
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
11
01
2020
accepted:
09
04
2020
pubmed:
6
5
2020
medline:
24
3
2021
entrez:
6
5
2020
Statut:
ppublish
Résumé
Combined radiochemotherapy followed by maintenance chemotherapy with cisplatin, lomustine and vincristine within the NOA-07 study resulted in considerable short-term toxicity in adult medulloblastoma patients. Here we investigated the long-term impact of this treatment, focusing on neurocognitive functioning and health-related quality of life (HRQoL). Neurocognitive functioning and HRQoL scores over time were determined, and differences between the post-treatment and follow-up assessments were calculated up to 18 months for neurocognition and 60 months for HRQoL. 28/30 patients were analyzed. The three preselected HRQoL scales (role, social and cognitive functioning) showed improved scores, to a clinically relevant extent (≥ 10 points), compared to post-treatment levels up to 30 months, but decreased afterwards. Z-scores for verbal working memory were worse during follow-up compared to post-treatment scores and remained impaired during 18 months follow-up (i.e. z-score below - 1 standard deviation). Attention was impaired post-treatment, and remained impaired to a clinically relevant extent during follow-up. Coordination/processing speed and lexical verbal fluency improved compared to post-treatment scores, and remained within the normal range thereafter. Other tests of verbal fluency were stable over time, with z-scores within the normal range. This long-term follow-up study showed that the NOA-07 treatment regimen was not associated with a deterioration in HRQoL in the post-treatment period. Verbal working memory deteriorated, while other neurocognitive domains did not seem to be impacted negatively by the treatment.
Sections du résumé
BACKGROUND
BACKGROUND
Combined radiochemotherapy followed by maintenance chemotherapy with cisplatin, lomustine and vincristine within the NOA-07 study resulted in considerable short-term toxicity in adult medulloblastoma patients. Here we investigated the long-term impact of this treatment, focusing on neurocognitive functioning and health-related quality of life (HRQoL).
METHODS
METHODS
Neurocognitive functioning and HRQoL scores over time were determined, and differences between the post-treatment and follow-up assessments were calculated up to 18 months for neurocognition and 60 months for HRQoL.
RESULTS
RESULTS
28/30 patients were analyzed. The three preselected HRQoL scales (role, social and cognitive functioning) showed improved scores, to a clinically relevant extent (≥ 10 points), compared to post-treatment levels up to 30 months, but decreased afterwards. Z-scores for verbal working memory were worse during follow-up compared to post-treatment scores and remained impaired during 18 months follow-up (i.e. z-score below - 1 standard deviation). Attention was impaired post-treatment, and remained impaired to a clinically relevant extent during follow-up. Coordination/processing speed and lexical verbal fluency improved compared to post-treatment scores, and remained within the normal range thereafter. Other tests of verbal fluency were stable over time, with z-scores within the normal range.
CONCLUSIONS
CONCLUSIONS
This long-term follow-up study showed that the NOA-07 treatment regimen was not associated with a deterioration in HRQoL in the post-treatment period. Verbal working memory deteriorated, while other neurocognitive domains did not seem to be impacted negatively by the treatment.
Identifiants
pubmed: 32367436
doi: 10.1007/s11060-020-03502-y
pii: 10.1007/s11060-020-03502-y
pmc: PMC7280359
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
117-130Références
J Clin Oncol. 1998 Jan;16(1):139-44
pubmed: 9440735
Neuro Oncol. 2016 Mar;18(3):435-44
pubmed: 26385615
Cancer. 2018 Aug;124(16):3390-3400
pubmed: 29905942
Dev Neurorehabil. 2019 Jan;22(1):19-26
pubmed: 29336639
Ann Neurol. 2003 Oct;54(4):514-20
pubmed: 14520665
J Neurooncol. 2017 Dec;135(3):433-441
pubmed: 28828582
Int J Radiat Oncol Biol Phys. 2007 Jun 1;68(2):433-40
pubmed: 17498567
Cortex. 2010 Jul-Aug;46(7):869-79
pubmed: 19853848
J Neurooncol. 2003 Jun;63(2):179-86
pubmed: 12825822
J Neurooncol. 2019 Mar;142(1):39-48
pubmed: 30607709
Int J Radiat Oncol Biol Phys. 1999 Aug 1;45(1):137-45
pubmed: 10477017
J Clin Oncol. 2006 Sep 1;24(25):4202-8
pubmed: 16943538
Eur J Cancer. 2010 Apr;46(6):1033-40
pubmed: 20181476
Lancet Neurol. 2009 Sep;8(9):810-8
pubmed: 19665931
Stereotact Funct Neurosurg. 2017;95(3):166-173
pubmed: 28531896
Arch Clin Neuropsychol. 2005 Jun;20(4):517-29
pubmed: 15896564
Neuro Oncol. 2015 Aug;17(8):1114-20
pubmed: 25862766
Neuro Oncol. 2017 May 1;19(5):689-698
pubmed: 28039368
J Neurooncol. 2018 Jan;136(1):95-104
pubmed: 29019042
Cancer Treat Rev. 1999 Feb;25(1):3-12
pubmed: 10212586
Eur J Cancer. 2011 Mar;47(5):667-75
pubmed: 21134739
Neuropsychologia. 2007 May 15;45(9):2016-24
pubmed: 17379262
Lancet Oncol. 2016 Nov;17(11):1533-1542
pubmed: 27686943
Psychooncology. 2019 Jan;28(1):131-138
pubmed: 30315720
J Clin Oncol. 2015 Jul 1;33(19):2166-75
pubmed: 26014298
J Natl Cancer Inst. 1993 Mar 3;85(5):365-76
pubmed: 8433390
Clin Endocrinol (Oxf). 2008 Nov;69(5):775-84
pubmed: 18462264
Qual Life Res. 1996 Feb;5(1):139-50
pubmed: 8901377
Lancet. 2002 Nov 2;360(9343):1361-8
pubmed: 12423981
Oncotarget. 2018 Jul 10;9(53):30189-30198
pubmed: 30046397
J Neurooncol. 2009 Nov;95(2):271-279
pubmed: 19521664
Neurooncol Pract. 2014 Jun;1(2):40-46
pubmed: 26034615
J Cancer Res Clin Oncol. 2017 Sep;143(9):1815-1821
pubmed: 28434043
Cerebellum. 2007;6(3):159-62
pubmed: 17786810
Annu Rev Neurosci. 2018 Jul 8;41:207-232
pubmed: 29641939
J Neurol Sci. 2008 Oct 15;273(1-2):19-24
pubmed: 18640690
J Clin Oncol. 2011 Jul 1;29(19):2717-23
pubmed: 21632505
Neurooncol Pract. 2018 May;5(2):129-138
pubmed: 31385978
J Clin Oncol. 2019 Mar 20;37(9):731-740
pubmed: 30730781
J Clin Oncol. 2001 Apr 15;19(8):2302-8
pubmed: 11304784
Neurooncol Pract. 2017 Jun;4(2):82-97
pubmed: 31385962
Eur J Cancer. 2015 Jul;51(10):1321-30
pubmed: 25899986
Arch Clin Neuropsychol. 2004 Mar;19(2):203-14
pubmed: 15010086
Dev Med Child Neurol. 2000 Nov;42(11):741-5
pubmed: 11104345
Neuro Oncol. 2018 Feb 19;20(3):400-410
pubmed: 29016837
Trends Cogn Sci. 2013 May;17(5):241-54
pubmed: 23579055
Health Qual Life Outcomes. 2018 Jun 4;16(1):114
pubmed: 29866185
J Clin Oncol. 2007 Sep 1;25(25):4023; author reply 4024-5
pubmed: 17761992
J Clin Oncol. 2014 Jun 10;32(17):1760-8
pubmed: 24516024
J Neurooncol. 2005 May;72(3):245-53
pubmed: 15937648
Acta Neuropathol. 2011 Aug;122(2):231-40
pubmed: 21681522
Eur J Cancer. 2013 Mar;49(4):893-903
pubmed: 23182688
Neuro Oncol. 2017 Feb 1;19(2):259-269
pubmed: 27540083
J Child Neurol. 2016 Oct;31(12):1341-53
pubmed: 26336203
Eur J Cancer. 2015 Nov;51(16):2434-43
pubmed: 26254812