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12 - Brain metastases

Published online by Cambridge University Press:  13 August 2009

By
Deepak Khuntia ,
Beela S. Mathew ,
Christina A. Meyers ,
Sterling Johnson  and
Minesh P. Mehta
Edited by
Christina A. Meyers  and
James R. Perry
Christina A. Meyers
Affiliation:
University of Texas, M. D. Anderson Cancer Center
James R. Perry
Affiliation:
University of Toronto
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Summary

Introduction

Brain metastasis is the commonest intracranial tumor in adults. In the United States, approximately 170 000 patients are diagnosed with brain metastases every year (Greenberg et al., 1999; Mehta & Tremont-Lukas, 2004). The rise in incidence is attributed to a number of factors including increased life expectancy, improved control of systemic disease, and better imaging capabilities that facilitate diagnosis of smaller lesions (Wen et al., 2001). While it is recognized that the overall prognosis of these patients remains poor, newer treatment methods have led to improved survival in subsets of patients. Patients with brain metastases often suffer from a variety of neurological, cognitive, and emotional difficulties. It is known that even subtle impairments of cognitive function can adversely affect the quality of life, an issue that was largely ignored earlier due to the dismal outcome. However, in the changing scenario of improved survival, recognizing the effects of the disease and its therapies on neurocognitive outcomes is important in formulating treatment modifications and strategies for rehabilitation that will enable patients to maximize their functional ability. This chapter briefly reviews the incidence and management of brain metastases as relevant to neurocognitive problems in cancer patients, discusses the etiology and pathogenesis of cognitive deficits in these patients, and suggests preventive and therapeutic strategies based on current understanding.

Overview of brain metastases

Epidemiology

Brain metastasis is a major debilitating complication affecting cancer patients. Autopsy data indicate that approximately 24% of adult cancer patients develop metastatic brain disease during the course of their cancer (Posner, 1995).

Type
Chapter
Information
Cognition and Cancer , pp. 170 - 186
Publisher: Cambridge University Press
Print publication year: 2008

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References

Abrey, , Olson, JD, Raizer, JJet al. (2001). A phase II trial of temozolomide for patients with recurrent or progressive brain metastases. J Neurooncol 53: 259–265.CrossRefGoogle ScholarPubMed
Agboola, O, Benoit, B, Cross, Pet al. (1998). Prognostic factors derived from recursive partitioning analysis (RPA) of Radiation Therapy Oncology Group (RTOG) brain metastases trials applied to surgically resected and irradiated brain metastatic cases. Int J Radiat Oncol Biol Phys 42: 155–159.CrossRefGoogle Scholar
Ahles, TA, Saykin, AJ, Furstenberg, CTet al. (2002). Neuropsychologic impact of standard dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma. J Clin Oncol 20: 485–493.CrossRefGoogle ScholarPubMed
Alexander, E, Loeffler, JS (1999). The case for radiosurgery. Clin Neurosurg 45: 32–40.Google ScholarPubMed
Andrews, DW, Scott, CB, Sperduto, PWet al. (2004). Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomized trial. Lancet 363(9422): 1665–1672.CrossRefGoogle Scholar
Antonadou, D, Coliarakis, N, Paraskevaidis, Met al. (2002a). Whole brain radiotherapy alone or in combination with temozolomide for brain metastases. A phase III study [abstract]. Int J Radiat Oncol Biol Phys 54: 93–94.CrossRefGoogle Scholar
Antonadou, D, Paraskevaidis, M, Sarris, Get al. (2002b). Phase II randomized trial of temozolomide and concurrent radiotherapy in patients with brain metastases. J Clin Oncol 20: 3644–3650.CrossRefGoogle ScholarPubMed
Aoyama, H, Shirato, H, Tago, Met al. (2006). Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. J Am Med Assoc 295(25): 2483–2491.CrossRefGoogle Scholar
Arriagada, R, LeChevalier, T, Borie, Fet al. (1995). Prophylactic cranial irradiation for patients with small cell lung cancer in complete remission. J Natl Cancer Inst 87: 183–190.CrossRefGoogle ScholarPubMed
Bambakidis, NC, Miller, RH (2004). Transplantation of oligodendrocyte precursors and sonic hedgehog results in improved function and white matter sparing in the spinal cords of adult rats after contusion. Spine J 4(1):16–26.CrossRefGoogle Scholar
Blakemore, WF, Gilson, JM, Crang, AJ (2003). The presence of astrocytes in areas of demyelination influences remyelination following transplantation of oligodendrocyte progenitors. Exp Neurol 184(2): 955–963.CrossRefGoogle Scholar
Boldrey, E, Sheline, G (1967). Delayed transitory clinical manifestation after radiation treatment of intracranial tumors. Acta Radiol 5: 5–10.CrossRefGoogle Scholar
Borgelt, B, Gelber, R, Kramer, Set al. (1980). The palliation of brain metastases: final results of the first two studies by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys 6: 1–9.CrossRefGoogle ScholarPubMed
Borgelt, B, Gelber, R, Larson, Met al. (1981). Ultra-rapid high dose irradiation schedules for the palliation of brain metastases: final results of the first two studies by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys 7: 1633–1638.CrossRefGoogle ScholarPubMed
Bradley, KA, Mehta, MP (2004). Management of brain metastases. Semin Oncol 31: 693–701.CrossRefGoogle ScholarPubMed
Breneman, JC, Warnick, RE, Albright, REJet al. (1997). Stereotactic radiosurgery for the treatment of brain metastases. Results of a single institution series. Cancer 79: 551–557.3.0.CO;2-2>CrossRefGoogle ScholarPubMed
Brezden, CB, Phillips, KA, Abdolell, M (2000). Cognitive function in breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol 18: 2695–2701.CrossRefGoogle ScholarPubMed
Burger, PC, Mahaley, MS, Dudka, Let al. (1979). The morphologic effects of radiation administered therapeutically for intracranial gliomas: a postmortem study of 25 cases. Cancer 44: 1256–1279.3.0.CO;2-T>CrossRefGoogle ScholarPubMed
Cammer, W (2000). Effects of TNFalpha on immature and mature oligodendrocytes and their progenitors invitro. Brain Res 864(2): 213–219.CrossRefGoogle Scholar
Cappuzo, F, Mazzoni, F, Maestri, Aet al. (2000). Medical treatment of brain metastases from solid tumors. Forum (Genova) 10: 137–148.Google Scholar
Chatani, M, Teshima, T, Hata, Ket al. (1986). Prognostic factors in patients with brain metastases from lung carcinoma. Strahlenther Onkol 162: 157–161.Google ScholarPubMed
Chatani, M, Matayoshi, Y, Masaki, Net al. (1994). Radiation therapy for brain metastases from lung carcinoma. Prospective randomized trial according to the level of lactate dehydrogenase. Strahlenther Onkol 170: 155–161.Google ScholarPubMed
Chougule, PB, Burton-Williams, M, Saris, Set al. (2000). Randomized treatment of brain metastases with gamma knife radiosurgery, whole brain radiotherapy or both [abstract]. Int J Radiat Oncol Biol Phys 48: 114CrossRefGoogle Scholar
Chow, BM, Li, YQ, Wong, CS. (2000). Radiation-induced apoptosis in the adult central nervous system is p53-dependent. Cell Death Differ 7(8): 712–720.CrossRefGoogle Scholar
Christodoulou, C, Bafaloukos, D, Kosmidis, Pet al. (2001). Phase II study of temozolomide in heavily pretreated cancer patients with brain metastases. Ann Oncol 12: 249–254.CrossRefGoogle ScholarPubMed
Crossen, JR, Garwood, D, Glatstein, Eet al. (1994). Neurobehavioral sequelae of cranial irradiation in adults: a review of radiation induced encephalopathy. J Clin Oncol 12: 627–642.CrossRefGoogle ScholarPubMed
Curran, W, Mehta, MP, Terhaard, Cet al. (2002). Predictors of Survival for Patients with Brain Metastases: Results of a Randomized Phase III Trial [abstract 155]. Int J Radiat Oncol Biol Phys 54: 93.CrossRefGoogle Scholar
Danysz, W, Parsons, CG, Mobius, JHet al. (2000). Neuroprotective and symptomatological action of memantine relevant for Alzheimer's disease: a unified glutamatergic hypothesis on the mechanism of action. Neurotoxicity Res 2: 85–97.CrossRefGoogle ScholarPubMed
DeAngelis, LM, Delattre, JY, Posner, JB (1989). Radiation induced dementia in patients cured of brain metastases. Neurology 39: 789–796.CrossRefGoogle ScholarPubMed
Dropcho, EJ (2005). Paraneoplastic disorders of the nervous system. In Black, PM, Loeffler, JS (eds.) Cancer of the Nervous System, (pp. 691–714). Philadelphia, PA: Lippincott Williams & Wilkins.Google Scholar
Ellis, R, Gregor, A (1998). The treatment of brain metastases from lung cancer. Lung Cancer 20: 81–84.CrossRefGoogle ScholarPubMed
Feldman, H, Gauthier, S, Hecker, Jet al. (2005). Efficacy and safety of donepezil in patients with more severe Alzheimer's disease: a subgroup analysis from a randomized placebo-controlled trial. Int J Geriatr Psychiatry 20(6): 559–569.CrossRefGoogle Scholar
Fontanella, M, Perozzo, P, Ursone, Ret al. (2003). Neuropsychological assessment after microsurgical clipping or endovascular treatment for anterior communicating artery aneurysm. Acta Neurochir 145: 867–872.CrossRefGoogle ScholarPubMed
Freidman, MA, Meyers, CA, Sawaya, R (2003). Neuropsychological effects of third ventricular tumor surgery. Neurosurgery 52: 791–798.CrossRefGoogle Scholar
Gaspar, L, Scott, C, Rotman, Met al. (1997). Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 37(4): 745–751.CrossRefGoogle Scholar
Gottwald, B, Wilde, B, Mihajlovic, Zet al. (2004). Evidence for distinct cognitive deficits after focal cerebellar lesions. J Neurol Neurosurg Psychiatry 75: 1524–1531.CrossRefGoogle ScholarPubMed
Graus, F, Walker, RW, Allen, JC (1983). Brain metastases in children. J Pediatr 103(4): 558–561.CrossRefGoogle Scholar
Green, HJ, Pakenham, KI, Headley, BCet al. (2002). Altered cognitive function in men treated for prostate cancer with luteinising hormone-releasing hormone analogues and cyproterone acetate: a randomized controlled trial. Br J Urol 90: 427–432.CrossRefGoogle ScholarPubMed
Greenberg, H, Chandler, WF, Sandler, HM (1999). Brain metastases. In: Greenberg, H, Chandler, WF, Sandler, HM (eds.) Brain Tumors, (pp. 299–317, Vol. 54). New York: Oxford University Press.Google Scholar
Gregor, A, Cull, A, Stephens, RJet al. (1997). Prophylactic cranial irradiation is indicated following complete response to induction therapy in small cell lung cancer: results of a multicenter randomized trial. United Kingdom Coordinating Committee for Cancer Research (UKCCCR) and the European Organisation for Research and Treatment of Cancer (EORTC). Eur J Cancer 33: 1752–1758.CrossRefGoogle Scholar
Grill, J, Viguier, D, Kieffer, Vet al. (2004). Critical risk factors for intellectual impairment in children with posterior fossa tumors: the role of cerebellar damage. J Neurosurg 101: 152–158.Google ScholarPubMed
Groves, AK, Barnett, SC, Franklin, RJet al. (1993). Repair of demyelinated lesions by transplantation of purified O-2A progenitor cells. Nature 362(6419): 453–455.CrossRefGoogle Scholar
Haie-Meder, C, Pellae-Cosset, B, Laplanche, Aet al. (1993). Results of a randomized clinical trial comparing two radiation schedules in the palliative treatment of brain metastases. Radiother Oncol 26: 111–116.CrossRefGoogle ScholarPubMed
Harwood, AR, Simson, WJ (1977). Radiation therapy of cerebral metastases: a randomized prospective clinical trial. Int J Radiat Oncol Biol Phys 2: 1091–1094.CrossRefGoogle ScholarPubMed
Herman, MA, Tremont-Lukats, I, Meyers, CAet al. (2003). Neurocognitive and functional assessment of patients with brain metastases. Am J Clin Oncol 26(3): 273–279.CrossRefGoogle Scholar
Hoerr, R (2003). Behavioral and psychological symptoms of dementia (BPSD): effects of EGb 761. Pharmacopsychiatry 36 [Suppl. 1]: S56–S61.Google ScholarPubMed
Hulshof, MC, Stark, NM, Kleij, Aet al. (2002). Hyperbaric oxygen therapy for cognitive disorders after irradiation of the brain. Strahlenther Onkol 178(4): 192–198.CrossRefGoogle Scholar
Hutter, BO, Spetzger, U, Bertalanffy, Het al. (1997). Cognition and quality of life in patients after transcallosal microsurgery for midline tumors. J Neurosurg Sci 41: 123–129.Google ScholarPubMed
Izquierdo, I, da Cunha, C, Rosat, Ret al. (1992). Neurotransmitter receptors involved in post-training memory processing by the amygdala, medial septum, and hippocampus of the rat. Behav Neural Biol 58(1): 16–26.CrossRefGoogle Scholar
Jatoi, A, Kahanic, SP, Frytag, Set al. (2005). Donepezil and vitamin E for preventing cognitive dysfunction in small cell lung cancer patients: preliminary results and suggestions for future study designs. Support Care Cancer 13(1): 66–69.CrossRefGoogle Scholar
Juengling, FD, Ebert, D, Gut, Oet al. (2000). Prefrontal cortical hypometabolism during low-dose interferon alpha treatment. Psychopharmacology (Berl) 152: 383–389.CrossRefGoogle ScholarPubMed
Karatekin, C, Lazareff, JA, Asarnow, RF (2000). Relevance of cerebellar hemispheres for executive functions. Pediatr Neurol 22: 106–112.CrossRefGoogle ScholarPubMed
Kauer, JA, Manlenka, RC, Nicoll, RA (1988). NMDA application potentiates synaptic transmission in the hippocampus. Nature 334(6179): 250–252.CrossRefGoogle Scholar
Kelly, K, Bunn, PAJ (1998). Is it time to reevaluate our approach to the treatment of brain metastases in patients with non-small cell lung cancer? Lung Cancer 20: 85–91.CrossRefGoogle ScholarPubMed
Kelley, KW, Bluthé, RM, Dantzer, Ret al. (2003). Cytokine-induced sickness behavior. Brain Behav Immun 17: S112–S118.CrossRefGoogle ScholarPubMed
Kershner, P, Wang-Cheng, R (1989). Psychiatric side-effects of steroid therapy. Psychosomatics 30: 135–139.CrossRefGoogle ScholarPubMed
Klein, M, Engelberts, NHJ, Ploeg, HMet al. (2003). Epilepsy in low grade gliomas: the impact on cognitive function and quality of life. Ann Neurol 54: 514–520.CrossRefGoogle ScholarPubMed
Knighton, , Hunt, TK, Schenestuhl, Het al. (1983). Oxygen tension regulates the expression of angiogenesis factor by macrophages. Science 221: 1283–1289.CrossRefGoogle ScholarPubMed
Kohshi, K, Imada, H, Nomoto, Set al. (2003). Successful treatment of radiation-induced brain necrosis by hyperbaric oxygen therapy. J Neurol Sci 209(1–2): 115–117.CrossRefGoogle ScholarPubMed
Komaki, R, Meyers, CA, Shin, DMet al. (1995). Evaluation of cognitive function in patients with limited small cell lung cancer prior to and shortly following prophylactic cranial irradiation. Int J Radiat Oncol Biol Phys 33(1): 179–182.CrossRefGoogle Scholar
Kondzoilka, D, Patel, A, Lunsford, LDet al. (1999). Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases. Int J Radiat Oncol Biol Phys 45(2): 427–434.CrossRefGoogle Scholar
Kramer, S (1968). The hazards of therapeutic irradiation of the central nervous system. Clin Neurosurg 15: 301–318.CrossRefGoogle ScholarPubMed
Kurtz, JM, Gelber, R, Brady, LWet al. (1981). The palliation of brain metastases in a favorable patient population: a randomized clinical trial by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys 7: 891–895.CrossRefGoogle Scholar
Lassman, AB, DeAngelis, LM (2003). Brain metastases. Neurol Clin 21(I): I,vii.Google Scholar
LeBars, PL (2003). Response patterns of EGb 761 in Alzheimer's disease: influence of neuropsychological profiles. Pharmacopsychiatry Jun; 36 [Suppl 1]: S44–S49.Google Scholar
Lee, AW, Kwong, DLW, Leung, SFet al. (2002). Factors affecting risk of symptomatic temporal lobe necrosis: significance of fractional dose and treatment time. Int J Radiat Oncol Biol Phys 53: 75–85.CrossRefGoogle ScholarPubMed
Levin, ED, Sledge, D, Baruah, Aet al. (2003). Ventral hippocampal NMDA blockade and nicotinic effects on memory function. Brain Res Bull 61(5): 489–495.CrossRefGoogle Scholar
Leyland-Jones, B, Semiglazov, V, Pawlicki, Met al. (2005). Maintaining normal hemoglobin levels with epoetin alfa in mainly nonanemic patients with metastatic breast cancer receiving first-line chemotherapy: a survival study. J Clin Oncol 23: 5960–5972.CrossRefGoogle ScholarPubMed
Li, J, Bentzen, SM, Renschler, M, Mehta, MP (2006). Improvement in neurocognitive function (NCF) correlates with tumor regression after whole brain radiation therapy (WBRT) for brain metastases (BM) [abstract]. Proc Am Soc Clin Oncol 24 [Suppl. 18S]: 1504.Google Scholar
Lilja, A, Smith, GJ, Salford, LG (1992). Microprocesses in perception and personality. J Nerv Ment Dis 180: 82–88.CrossRefGoogle Scholar
Lim, LC, Rosenthal, MA, Maartens, Net al. (2004). Management of brain metastases. Intern Med J 34: 270–278.CrossRefGoogle ScholarPubMed
Magy, L, Mertens, C, Avellana-Adalid, Vet al. (2003). Inducible expression of FGF2 by a rat oligodendrocyte precursor cell line promotes CNS myelination in vitro. Exp Neurol 184(2): 912–922.CrossRefGoogle Scholar
Marx, RE, Johnson, RP, Kline, SN (1985). Prevention of osteoradionecrosis: a randomized prospective clinical trial of hyperbaric oxygen versus penicillin. J Am Dent Assoc 111; 49–54.CrossRefGoogle ScholarPubMed
McEwen, BS, Alves, SE (1999). Estrogen actions in the central nervous system. Endocr Rev 20: 279–307.Google ScholarPubMed
Mehta, MP, Tremont-Lukas, I (2004). Radiosurgery for single and multiple metastases. In Sawaya, R (ed.) Intracranial Metastases: Current Management Strategies, (pp. 139–164). Malden MA: Blackwell.CrossRefGoogle Scholar
Mehta, MP, Shapiro, WR, Glantz, Met al. (2002). Lead-in phase to randomized trial of Motexafin Gadolinium and whole brain radiation for patients with brain metastases. Centralized assessment of magnetic resonance imaging, neurocognitive and neurologic end points. J Clin Oncol 20: 3445–3453.CrossRefGoogle ScholarPubMed
Mehta, MP, Rodrigus, P, Terhaard, CHJ et al: (2003). Survival and neurologic outcomes in a randomized trial of Motexafin Gadolinium and whole brain radiation therapy in brain metastases. J Clin Oncol 21: 2529–2536.CrossRefGoogle Scholar
Mehta, MP, Gervais, R, Chabot, Pet al. (2006). Motexafin gadolinium (MGd) combined with prompt whole brain radiation therapy (RT) prolongs time to neurologic progression in non-small cell lung cancer (NSCLC) patients with brain metastases: Results of a phase III trial [abstract]. Proc Am Soc Clin Oncol 24 [Suppl. 18S]: 7014.Google Scholar
Meyers, CA, Abbruzzese, JL (1992). Cognitive functioning in cancer patients: effect of previous treatment. Neurology 42: 434–436.CrossRefGoogle ScholarPubMed
Meyers, CA, Boake, C (1993). Neurobehavioral disorders experienced by brain tumor patients: rehabilitation strategies. Cancer Bull 45: 362–364.Google Scholar
Meyers, CA, Hess, KR (2003). Multifaceted endpoints in brain tumor clinical trials: cognitive deterioration precedes MRI progression. Neurooncology 5: 89–95.Google Scholar
Meyers, CA, Valentine, AD, Wong, FCLet al. (1994). Reversible neurotoxicity of interleukin-2 and tumor necrosis factor: correlation of SPECT with neuropsychological testing. J Neuropsychiatry Clin Neurosci 6: 285–288.Google ScholarPubMed
Meyers, CA, Weitzner, MA, Valentine, et al. (1998). Methylphenidate therapy improves cognition, mood, and function of brain tumor patients. J Clin Oncol 16(7): 2522–2527.CrossRefGoogle Scholar
Meyers, CA, JA, Smith, Bezjak, Aet al. (2004). Neurocognitive function and progression in patients with brain metastases treated with whole brain radiation and Motexafin Gadolinium: results of a randomized phase III trial. J Clin Oncol 22(1): 157–165.CrossRefGoogle ScholarPubMed
Mix, JA, Crews, WD (2002). A double-blind, placebo-controlled, randomized trial of Ginkgo biloba extract EGb 761 in a sample of cognitively intact older adults: neuropsychological findings. Hum Psychopharmacol 17(6): 267–277.CrossRefGoogle Scholar
Monje, ML, Palmer, T (2003). Radiation injury and neurogenesis. Curr Opin Neurol 16: 129–134.CrossRefGoogle ScholarPubMed
Murray, KJ, Scott, C, Greenberg, HMet al. (1997). A randomized phase III study of accelerated hyperfractionation versus standard in patients with unresected brain metastases: a report of the Radiation Therapy Oncology Group (RTOG) 9104. Int J Radiat Oncol Biol Phys 39: 571–574.CrossRefGoogle ScholarPubMed
Nieder, C, Berberich, W, Schnabel, K (1997). Tumor-related prognostic factors for remission of brain metastases after radiotherapy. Int J Radiat Oncol Biol Phys 39: 25–30.CrossRefGoogle ScholarPubMed
Noordjik, EM, Vecht, CJ, Haaxma-Reiche, Het al. (1994). The choice of treatment of single brain metastases should be based on extracranial tumor activity and age. Int J Radiat Oncol Biol Phys 29: 711–717.CrossRefGoogle Scholar
Nussbaum, ES, Djalilian, HR, Cho, Ket al. (1996). Brain metastases: histology, multiplicity, surgery and survival. Cancer 78(8): 1781–1788.3.0.CO;2-U>CrossRefGoogle Scholar
Patchell, RA, Tibbs, PA, Walsh, JWet al. (1990). A randomized trial of surgery in the treatment of single metastases to the brain. N Eng J Med 322(8): 494–500.CrossRefGoogle Scholar
Patchell, RA, Tibbs, PA, Regine, WFet al. (1998). Postoperative radiotherapy in the treatment of single metastases to the brain: a randomized trial. J Am Med Assoc 280: 1485–1489.CrossRefGoogle ScholarPubMed
Peace, KA, Orme, SM, Thompson, AR (1997). Cognitive dysfunction in patients treated for pituitary tumors. J Clin Exp Neuropsychol 19: 1–6.CrossRefGoogle Scholar
Peissner, W, Kocher, M, Treuer, H (1999). Ionizing radiation-induced apoptosis of proliferating stem cells in the dentate gyrus of the adult rat hippocampus. Brain Res Mol Brain Res 71(1): 61–68.CrossRefGoogle Scholar
Penitzka, S, Steinvorth, S, Sehlleier, Set al. (2002). Assessment of cognitive function after preventive and therapeutic whole brain irradiation using neuropsychological testing. Strahlenther Onkol 178: 252–258.CrossRefGoogle ScholarPubMed
Pirzkall, A, Debus, J, Lohr, Fet al. (1998). Radiosurgery alone or in combination with whole-brain radiotherapy for brain metastases. J Clin Oncol 16: 3563–3569.CrossRefGoogle ScholarPubMed
Posner, JB (1995). Neurologic Complications of Cancer. Philadelphia, PA: FA Davis.Google Scholar
Postmus, PE, Haaxma-Reiche, H, Smit, EFet al. (2000). Treatment of brain metastases of small-cell lung cancer: comparing teniposide and teniposide with whole-brain radiotherapy. A phase III study of the European Organization for the Research and Treatment of Cancer Lung Cancer Cooperative Group. J Clin Oncol 18: 3400–3408.CrossRefGoogle ScholarPubMed
Quan, AL, Videtic, GM, Suh, JH (2004). Brain metastases in small cell lung cancer. Oncology 18: 961–72.Google ScholarPubMed
Regine, WF, Scott, C, Murray, Ket al. (2001). Neurocognitive outcome in brain metastases patients treated with accelerated-fractionation vs accelerated hyperfractionated radiotherapy: an analysis of RTOG study91–04. Int J Radiat Oncol Biol Phys 51: 711–717.CrossRefGoogle Scholar
Regine, WF, Schmitt, FA, Scott, CBet al. (2004). Feasibility of neurocognitive outcome evaluations in patients with brain metastases in a multi-institutional cooperative group setting: results of Radiation Therapy Oncology Group trial BR-0018. Int J Radiat Oncol Biol Phys 58(5): 1346–1352.CrossRefGoogle Scholar
Renschler, M, Mehta, MP, Donald, DMet al. (2003). Treatment intent for brain metastases: surveys of medical and radiation oncologists indicate that maintaining neurologic and neurocognitive function is more important than prolonging survival. Proc Am Soc Clin Oncol 22: 552 (no. 2222).Google Scholar
Rich, JB, Maki, P (1999). Estrogen, testosterone and the brain: a review of neuropsychological, aging and neuroimaging studies. J Int Neuropsychol Soc 6: iii.Google Scholar
Riedel, G, Reymann, KG (1996). Metabotropic glutamate receptors in hippocampal long-term potentiation and learning and memory. Acta Physiol Scand 157(1): 1–19.CrossRefGoogle Scholar
Roman, G (2000). Perspectives in the treatment of vascular dementia. Drugs Today (Barc) 36(9): 641–653.CrossRefGoogle Scholar
Salminen, E, Porten, R, Korpela, Jet al. (2003). Androgen deprivation and cognition in prostate cancer. Br J Cancer 89: 971–976.CrossRefGoogle ScholarPubMed
Sanghavi, SN, Miranpuri, SS, Chappell, Ret al. (2001). Radiosurgery for patients with brain metastases: a multi-institutional analysis stratified by the RTOG recursive partitioning analysis method. Int J Radiat Oncol Biol Phys 51: 426–434.CrossRefGoogle ScholarPubMed
Sawaya, R, Bindal, R (2001). Metastatic brain tumors. In Laws, E, Kaye, AH (eds.) Brain Tumors: an Encyclopedic Approach (pp. 923–946). Edinburgh: Churchill Livingstone.Google Scholar
Schagen, SB, vanDam, FS, Muller, MJet al. (1999). Cognitive deficits after postoperative chemotherapy for breast cancer. Cancer 85: 640–650.3.0.CO;2-G>CrossRefGoogle Scholar
Scheibel, RS, Meyers, CA, Levin, VA (1996). Cognitive dysfunction following surgery for intracerebral glioma: influence of histopathology, lesion location and treatment. J Neurooncol 30: 61–69.CrossRefGoogle ScholarPubMed
Schellinger, PD, Meinck, HM, Thron, A (1999). Diagnostic accuracy of MRI compared to CCT in patients with brain metastases. J Neurooncol 44(3): 275–281.CrossRefGoogle ScholarPubMed
Schultheiss, TE, Kun, , Ang, KKet al. (1995). Radiation response of the central nervous system. Int J Radiat Oncol Biol Phys 31: 1093–1112.CrossRefGoogle ScholarPubMed
Senzer, N (2002). Rationale for a phase III study of erythropoietin as a neurocognitive protectant in patients with lung cancer receiving prophylactic cranial irradiation. Semin Oncol 6 [Suppl. 19]: 47–52.CrossRefGoogle Scholar
Seung, SK, Sneed, PK, McDermott, MWet al. (1998). Gamma Knife radiosurgery for malignant melanoma brain metastases. Cancer J Sci Am 4: 103–109.Google ScholarPubMed
Shaw, E, Scott, C, Suh, Jet al. (2003). RSR13 plus cranial radiation therapy in patients with brain metastases: comparison with the Radiation Therapy Oncology Group recursive partitioning analysis brain metastases database. J Clin Oncol 21: 2364–2371.CrossRefGoogle ScholarPubMed
Sheline, GE, Wara, WM, Smith, V (1980). Therapeutic irradiation and brain injury. Int J Radiat Oncol Biol Phys 6: 1215–1228.CrossRefGoogle ScholarPubMed
Silverman, DH, Castellon, SA, Abraham, Let al. (2003). Abnormal regional brain metabolism in breast cancer survivors after adjuvant chemotherapy is associated with cognitive changes. Proc Am Soc Clin Oncol 22: 12.Google Scholar
Sundstrom, JT, Minn, H, Lertola, KKet al. (1998). Prognosis of patients treated for intracranial metastases with whole-brain irradiation. Ann Med 30: 296–299.CrossRefGoogle ScholarPubMed
Taphoorn, MJB (2003). Neurocognitive sequelae in the treatment of low grade gliomas. Semin Oncol 30 [6 Suppl. 19] 45–48.CrossRefGoogle ScholarPubMed
Tucha, O, Smely, C, Preier, M (2003). Preoperative and postoperative cognitive functioning in patients with frontal meningioma. J Neurosurg 98: 21–31.CrossRefGoogle Scholar
Turkheimer, E, Yeo, RA, Jones, CLet al. (1990). Quantitative assessment of covariation between neuropsychological function and location of naturally occurring lesions in human. J Clin Exp Neuropsychol 12: 549–565.CrossRefGoogle Scholar
Kogel, AJ (1986). Radiation-induced damage in the central nervous system: an interpretation of target cell responses. Br J Cancer 7: 207–217.Google ScholarPubMed
Oosterhout, AG, Boon, PJ, Houx, PJet al. (1995). Follow up of cognitive functioning in patients with small cell lung cancer. Int J Radiat Oncol Biol Phys 31: 911–914.CrossRefGoogle ScholarPubMed
Vannucci, RC, Baten, M (1974). Cerebral metastatic disease in childhood. Neurology 24(10): 981–985.CrossRefGoogle Scholar
Varney, NR, Syrop, C, Kubu, CSet al. (1998). Neuropsychologic dysfunction in women following leuprolide acetate induction of hypoestrogenism. J Assist Reprod Genet 10: 53–57.CrossRefGoogle Scholar
Verger, E, Gil, M, Yaya, Ret al. (2003). Concomitant temozolomide (TMZ) and whole brain radiotherapy (WBRT) in patients with brain metastases (BM): randomized multicentric phase II study [abstract]. Proc Am Soc Clin Oncol 22: 101.Google Scholar
Wefel, JS, Kayl, AE, Meyers, CA (2004a). Neuropsychological dysfunction associated with cancer and cancer therapies: a conceptual review of an emerging target. Br J Cancer 90: 1691–1696.CrossRefGoogle ScholarPubMed
Wefel, JS, Lenzi, R, Theriault, RLet al. (2004b). The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: results of a prospective randomized longitudinal trial. Cancer 100(11): 2292–2299.CrossRefGoogle Scholar
Weitzner, MA, Meyers, CA, Valentine, AD (1995). Methylphenidate in the treatment of neurobehavioral slowing associated with cancer and cancer treatment. J Neuropsychiatry Clin Neurosci 7: 347–350.Google ScholarPubMed
Wen, PY, Black, PM, Loeffler, JS (2001). Metastatic brain cancer. In Devita, VT, Hellman, S, Rosenberg, SA (eds.) Cancer: Principles and Practice of Oncology (6th edn.) (pp. 2655–2670). Philadelphia PA: Lippincott Williams & Wilkins.Google Scholar
Wieneke, MH, Dienst, ER (1995). Neuropsychological assessment of cognitive functioning following chemotherapy for breast cancer. Psychooncology 4: 61–66.CrossRefGoogle Scholar
Wolkowitz, OM, Reus, VI, Weingartner, Het al. (1990). Cognitive aspects of corticosteroids. Am J Psychiatry 147: 1297–1303.Google Scholar
Young, RF (1998). Radiosurgery for the treatment of brain metastases. Semin Surg Oncol 14: 70–78.3.0.CO;2-#>CrossRefGoogle ScholarPubMed
Zimm, S, Wampler, GL, Stablein, Det al. (1981). Intracerebral metastases in solid tumor patients: natural history and results of treatment. Cancer 48: 384–394.3.0.CO;2-8>CrossRefGoogle ScholarPubMed

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