Cumulative incidence of full cognitive recovery higher with postoperative SRS versus WBRT and for SRS alone versus SR + WBRT
By Elana Gotkine HealthDay Reporter
FRIDAY, Oct. 4, 2024 (HealthDay News) — Many patients with brain metastases who experience initial neurocognitive failure (NCF) following brain radiation therapy demonstrate recovery, with greater rates of cognitive recovery (CR) for stereotactic radiosurgery (SRS), according to a study presented at the annual meeting of the American Society for Radiation Oncology, held from Sept. 29 to Oct. 2 in Washington, D.C.
Hua Ren Ryan Cherng, M.D., from the University of Maryland Medical Center in Baltimore, and colleagues examined CR following initial NCF in patients treated with SRS and whole brain radiation therapy (WBRT) in a pooled analysis of three phase 3 randomized clinical trials. The analyses included 288 patients with trial-defined NCF.
The researchers found that the pooled cumulative incidence of full CR was 38 and 42 percent at six and 12 months after NCF onset, respectively. At the same time points, the incidence rates of improvement on any previously failed cognitive test were 73 and 76 percent, respectively. The cumulative incidence of full CR was significantly higher with postoperative SRS versus WBRT and for SRS alone versus SRS + WBRT (hazard ratios, 2.68 and 2.35, respectively). A trend toward a higher incidence of CR was seen for hippocampal-avoidance-WBRT versus WBRT. No difference was seen in the rates of improvement in cognitive tests based on treatment. Compared with WBRT, SRS was predictive of CR in a multivariable pooled analysis (hazard ratio, 2.42).
“Our research finds that the cognitive side effects of radiation treatment for people with brain metastases appear to be fully reversible, and patients appear to be able to sustain that recovery over the long term,” Cherng said in a statement.
Several authors disclosed ties to the biopharmaceutical industry.
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