ESTRO 2024 - Abstract Book

S743

Clinical - CNS

ESTRO 2024

118

Digital Poster

Early region-specific impact of adjuvant RT on cognition in adult patients with primary brain tumors

Beatriz Gutiérrez-García 1 , Cynthia M Cáceres 2 , Fidel Núñez-Marín 3 , Jaume Molero 1 , Lluis Prats 1 , Neus Mestre 4 , Silvia Martínez 2 , Pilar Teixidor 5 , Silvia Comas 1 , Carme Balañà 6 , Salvador Villà 1 1 Institut Català d'Oncologia, Radiation Oncology, Badalona, Spain. 2 Hospital Universitari Germans Trias i Pujol, Neuropsychology, Badalona, Spain. 3 Hospital de la Santa Creu i Sant Pau, Radiology, Barcelona, Spain. 4 Centro de Regulación Genómica, Biostatistics, Barcelona, Spain. 5 Hospital Universitari Germans Trias i Pujol, Neurosurgery, Badalona, Spain. 6 Institut Català d'Oncologia, Medical Oncology, Badalona, Spain

Purpose/Objective:

While treatments for primary brain tumors in adults increase survival, researchers are concerned about their cognitive sequelae. Neurocognition has an anatomical distribution that makes it susceptible to brain damage. This study aims to evaluate the contribution of radiotherapy to short-term cognitive impairment as compared with the contribution from the tumor itself plus surgical changes.

Material/Methods:

Using a prospective database of cognitive telerehabilitation in 78 adults who had undergone surgery for a primary brain tumor, a retrospective sub-analysis of the contribution of radiotherapy to the results has been performed. Thirty-four subdivisions of 12 anatomical regions associated to neurocognition have been delineated in the 48 irradiated patients and in the 30 non-irradiated patients. In the first group, the correlation between dose received by each region and degree of deterioration has been evaluated, and in the totality of patients the impact of the relationship with tumor and surgical changes on dysfunction has been calculated and compared with dose dependent response.

Results:

The correlation between cognitive status and radiation dose is especially strong and significant in the left hemisphere and in specific subdivisions such as the posterior hippocampus or the dorsolateral prefrontal cortex, with left prevailing over posterior dominance in most cognitive domains. Memory is the most affected domain right after the end of radiotherapy, while attention is the most affected domain three months later. The hippocampus is involved in various cognitive domains in addition to memory. The prefrontal subregions and the genu of the corpus callosum are more affected by the relationship with disease and surgical changes than by the radiation received. Irradiated patients do not benefit from cognitive rehabilitation.

Conclusion: