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Saturday, December 16, 2017

Association of neurocognitive deficits with radiotherapy or chemoradiotherapy for patients with head and neck cancer



A study by Zer and colleagues of the University from Toronto General Hospital investigated the short- and long-term neurocognitive deficits (NCD) after treatment in patients with head and neck cancer (HNC). The investigators evaluated 80 newly diagnosed patients with head and neck cancer and 40 noncancer controls over a period of 2 years. Most patients had oropharyngeal SCC (76%); and received cisplatin-based chemoradiation (61%). The neurocognitive domains assessed were: intellectual capacity, concentration/short-term attention span, visual memory, verbal memory, processing speed, executive function, and motor dexterity.

The investigators found that neurocognitive function, although not immediately affected after treatment, progressively declines in 38% of the patients in the 2 years after definitive treatment with chemotherapy or radiation. A retrospective study by the same investigators suggested an association between radiation therapy for HNC and NCD and demonstrated an association of temporal lobe and cerebellum radiation dose with impaired memory and motor dexterity, respectively. Chemotherapy-induced NCD have been documented in other cancer populations (e.g., breast cancer and hematologic malignancy).

The authors recommend that adverse cognitive risks should be communicated to patients and families, and strategies to reduce toxic effects and cognitive rehabilitation options should be available for HNC survivors.



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