Memory in low-grade glioma patients treated with radiotherapy or temozolomide: a correlative analysis of EORTC study 22033-26033.


Journal

Neuro-oncology
ISSN: 1523-5866
Titre abrégé: Neuro Oncol
Pays: England
ID NLM: 100887420

Informations de publication

Date de publication:
05 05 2021
Historique:
pubmed: 2 11 2020
medline: 21 5 2021
entrez: 1 11 2020
Statut: ppublish

Résumé

EORTC study 22033-26033 showed no difference in progression-free survival between high-risk low-grade glioma receiving either radiotherapy (RT) or temozolomide (TMZ) chemotherapy alone as primary treatment. Considering the potential long-term deleterious impact of RT on memory functioning, this study aims to determine whether TMZ is associated with less impaired memory functioning. Using the Visual Verbal Learning Test (VVLT), memory functioning was evaluated at baseline and subsequently every 6 months. Minimal compliance for statistical analyses was set at 60%. Conventional indices of memory performance (VVLT Immediate Recall, Total Recall, Learning Capacity, and Delayed Recall) were used as outcome measures. Using a mixed linear model, memory functioning was compared between treatment arms and over time. Neuropsychological assessment was performed in 98 patients (53 RT, 46 TMZ). At 12 months, compliance had dropped to 66%, restricting analyses to baseline, 6 months, and 12 months. At baseline, patients in either treatment arm did not differ in memory functioning, sex, age, or educational level. Over time, patients in both arms showed improvement in Immediate Recall (P = 0.017) and total number of words recalled (Total Recall; P < 0.001, albeit with delayed improvement in RT patients (group by time; P = 0.011). Memory functioning was not associated with RT gross, clinical, or planned target volumes. In patients with high-risk low-grade glioma there is no indication that in the first year after treatment, RT has a deleterious effect on memory function compared with TMZ chemotherapy.

Sections du résumé

BACKGROUND
EORTC study 22033-26033 showed no difference in progression-free survival between high-risk low-grade glioma receiving either radiotherapy (RT) or temozolomide (TMZ) chemotherapy alone as primary treatment. Considering the potential long-term deleterious impact of RT on memory functioning, this study aims to determine whether TMZ is associated with less impaired memory functioning.
METHODS
Using the Visual Verbal Learning Test (VVLT), memory functioning was evaluated at baseline and subsequently every 6 months. Minimal compliance for statistical analyses was set at 60%. Conventional indices of memory performance (VVLT Immediate Recall, Total Recall, Learning Capacity, and Delayed Recall) were used as outcome measures. Using a mixed linear model, memory functioning was compared between treatment arms and over time.
RESULTS
Neuropsychological assessment was performed in 98 patients (53 RT, 46 TMZ). At 12 months, compliance had dropped to 66%, restricting analyses to baseline, 6 months, and 12 months. At baseline, patients in either treatment arm did not differ in memory functioning, sex, age, or educational level. Over time, patients in both arms showed improvement in Immediate Recall (P = 0.017) and total number of words recalled (Total Recall; P < 0.001, albeit with delayed improvement in RT patients (group by time; P = 0.011). Memory functioning was not associated with RT gross, clinical, or planned target volumes.
CONCLUSION
In patients with high-risk low-grade glioma there is no indication that in the first year after treatment, RT has a deleterious effect on memory function compared with TMZ chemotherapy.

Identifiants

pubmed: 33130890
pii: 5948535
doi: 10.1093/neuonc/noaa252
pmc: PMC8099470
doi:

Substances chimiques

Antineoplastic Agents, Alkylating 0
Temozolomide YF1K15M17Y

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

803-811

Subventions

Organisme : Cancer Research UK
ID : 6850
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Neuro-Oncology.

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Auteurs

Martin Klein (M)

Brain Tumor Center Amsterdam at Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

A Josephine Drijver (AJ)

Brain Tumor Center Amsterdam at Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

Martin J van den Bent (MJ)

Brain Tumor Center at Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands.

Jacolien C Bromberg (JC)

Brain Tumor Center at Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands.

Khê Hoang-Xuan (K)

Department of Neuro-Oncology, La Pitié Salpêtrière University Hospitals, Sorbonne University, Paris, France.

Martin J B Taphoorn (MJB)

Department of Neurology, Haaglanden Medical Center, The Hague, Netherlands.
Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.

Jaap C Reijneveld (JC)

Brain Tumor Center Amsterdam at Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Foundation for Epilepsy Institutions in the Netherlands (SEIN), Heemstede, the Netherlands.

Mohamed Ben Hassel (M)

Department of Radiation Therapy, Eugène Marquis Center, Rennes, France.

Elodie Vauleon (E)

Department of Radiation Therapy, Eugène Marquis Center, Rennes, France.

Daniëlle B P Eekers (DBP)

Department of Radiation Oncology (MAASTRO), GROW‒School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands.
Proton Therapy Center South-East Netherlands (ZON-PTC), Maastricht, the Netherlands.

Tzahala Tzuk-Shina (T)

Oncology Institute, Rambam Health Care Campus, Haifa, Israel.

Anna Lucas (A)

Catalan Institute of Oncology, Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain.

Salvador Villà Freixa (SV)

Catalan Institute of Oncology, Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain.

Vasilis Golfinopoulos (V)

European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium.

Thierry Gorlia (T)

European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium.

Andreas F Hottinger (AF)

Department of Oncology and Clinical Neurosciences, Vaudois University Hospital Center and University of Lausanne, Lausanne, Switzerland.

Roger Stupp (R)

Department of Oncology and Clinical Neurosciences, Vaudois University Hospital Center and University of Lausanne, Lausanne, Switzerland.
Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Department of Neurological Surgery and Neurology, Northwestern Medicine and Northwestern University, Chicago, Illinois, USA.

Brigitta G Baumert (BG)

Department of Radiation Oncology (MAASTRO), GROW‒School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands.
Department of Radiation Oncology, Cantonal Hospital of Graubünden, Chur, Switzerland.

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