Long-term cognitive function, neuroimaging, and quality of life in primary CNS lymphoma

Nancy Doolittle, Agnieszka Korfel, Meredith A. Lubow, Elisabeth Schorb, Uwe Schlegel, Sabine Rogowski, Rongwei (Rochelle) Fu, Edit Dósa, Gerald Illerhaus, Dale Kraemer, Leslie Muldoon, Pasquale Calabrese, Nancy Hedrick, Rose Marie Tyson, Kristoph Jahnke, Leeza Maron, Robert W. Butler, Edward Neuwelt

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Objective: To describe and correlate neurotoxicity indicators in long-term primary CNS lymphoma (PCNSL) survivors who were treated with high-dose methotrexate-based regimens with or without whole-brain radiotherapy (WBRT). Methods: Eighty PCNSL survivors from 4 treatment groups (1 with WBRT and 3 without WBRT) who were a minimum of 2 years after diagnosis and in complete remission underwent prospective neuropsychological, quality-of-life (QOL), and brain MRI evaluation. Clinical characteristics were compared among treatments by using the x2 test and analysis of variance. The association among neuroimaging, neuropsychological, and QOL outcomes was assessed by using the Pearson correlation coefficient. Results: The median interval from diagnosis to evaluation was 5.5 years (minimum, 2 years; maximum, 26 years). Survivors treated with WBRT had lower mean scores in attention/executive function (p 5 0.0011), motor skills (p 5 0.0023), and neuropsychological composite score (p 5 0.0051) compared with those treated without WBRT. Verbal memory was better in survivors with longer intervals from diagnosis to evaluation (p 5 0.0045). On brain imaging, mean areas of total T2 abnormalities were different among treatments (p 5 0.0006). Total T2 abnormalities after WBRT were more than twice the mean of any non-WBRT group and were associated with poorer neuropsychological and QOL outcomes. Conclusions: Our results suggest that in patients treated for PCNSL achieving complete remission and surviving at least 2 years, the addition of WBRT to methotrexate-based chemotherapy increases the risk of treatment-related neurotoxicity. Verbal memory may improve over time. Classification of evidence: This study provides Class III evidence that in patients treated for PCNSL achieving complete remission and surviving at least 2 years, the addition of WBRT to methotrexatebased chemotherapy increases the risk of treatment-related neurotoxicity.

Original languageEnglish (US)
Pages (from-to)84-92
Number of pages9
JournalNeurology
Volume81
Issue number1
DOIs
StatePublished - Jul 2 2013

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Neuroimaging
Cognition
Lymphoma
Quality of Life
Radiotherapy
Brain
Survivors
Methotrexate
Cognitive Function
Central Nervous System
Therapeutics
Drug Therapy
Motor Skills
Executive Function
Analysis of Variance

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

Cite this

Doolittle, N., Korfel, A., Lubow, M. A., Schorb, E., Schlegel, U., Rogowski, S., ... Neuwelt, E. (2013). Long-term cognitive function, neuroimaging, and quality of life in primary CNS lymphoma. Neurology, 81(1), 84-92. https://doi.org/10.1212/WNL.0b013e318297eeba

Long-term cognitive function, neuroimaging, and quality of life in primary CNS lymphoma. / Doolittle, Nancy; Korfel, Agnieszka; Lubow, Meredith A.; Schorb, Elisabeth; Schlegel, Uwe; Rogowski, Sabine; Fu, Rongwei (Rochelle); Dósa, Edit; Illerhaus, Gerald; Kraemer, Dale; Muldoon, Leslie; Calabrese, Pasquale; Hedrick, Nancy; Tyson, Rose Marie; Jahnke, Kristoph; Maron, Leeza; Butler, Robert W.; Neuwelt, Edward.

In: Neurology, Vol. 81, No. 1, 02.07.2013, p. 84-92.

Research output: Contribution to journalArticle

Doolittle, N, Korfel, A, Lubow, MA, Schorb, E, Schlegel, U, Rogowski, S, Fu, RR, Dósa, E, Illerhaus, G, Kraemer, D, Muldoon, L, Calabrese, P, Hedrick, N, Tyson, RM, Jahnke, K, Maron, L, Butler, RW & Neuwelt, E 2013, 'Long-term cognitive function, neuroimaging, and quality of life in primary CNS lymphoma', Neurology, vol. 81, no. 1, pp. 84-92. https://doi.org/10.1212/WNL.0b013e318297eeba
Doolittle N, Korfel A, Lubow MA, Schorb E, Schlegel U, Rogowski S et al. Long-term cognitive function, neuroimaging, and quality of life in primary CNS lymphoma. Neurology. 2013 Jul 2;81(1):84-92. https://doi.org/10.1212/WNL.0b013e318297eeba
Doolittle, Nancy ; Korfel, Agnieszka ; Lubow, Meredith A. ; Schorb, Elisabeth ; Schlegel, Uwe ; Rogowski, Sabine ; Fu, Rongwei (Rochelle) ; Dósa, Edit ; Illerhaus, Gerald ; Kraemer, Dale ; Muldoon, Leslie ; Calabrese, Pasquale ; Hedrick, Nancy ; Tyson, Rose Marie ; Jahnke, Kristoph ; Maron, Leeza ; Butler, Robert W. ; Neuwelt, Edward. / Long-term cognitive function, neuroimaging, and quality of life in primary CNS lymphoma. In: Neurology. 2013 ; Vol. 81, No. 1. pp. 84-92.
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AU - Rogowski, Sabine

AU - Fu, Rongwei (Rochelle)

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