Neurocognitive function and progression in patients with brain metastases treated with whole-brain radiation and motexafin gadolinium: Results of a randomized phase III trial
Neurocognitive function and progression in patients with brain metastases treated with whole-brain radiation and motexafin gadolinium: Results of a randomized phase III trial
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DOI：
10.1200/jco.2004.05.128
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发表时间：
2004-01-01
影响因子：
45.3
通讯作者：
Renschler, MF
中科院分区：
文献类型：
--
作者：
Meyers, CA;Smith, JA;Renschler, MF
PurposeTo报告的神经认知结果在III期随机试验中评估生存和神经和神经认知功能的患者接受全脑放射治疗（WBRT）与或不与motexafin gadolinium.Patients和MethodsPatients接受WBRT 30戈伊，在10个部分与或不与MGd 5 mg/kg/d。每月神经认知测试的记忆，执行功能，和tine运动skills. ResultsFour-hundred-one患者参加（251与非小细胞肺癌，75与乳腺癌，和75与其他癌症）; 90.5%的患者有一个或多个神经认知测试在基线损害。基线时记忆、精细运动速度、执行功能和整体神经认知障碍的神经认知测试评分与脑肿瘤体积相关，并可预测生存率。治疗组间至神经认知进展的时间无统计学显著差异。肺癌患者（但不是其他类型的癌症）谁用MGd治疗往往有改善记忆和执行功能。（P = 0.062）和经设盲事件审查委员会评估的神经功能改善结论神经认知测验是反映脑功能的一个相对敏感的指标;肿瘤预后变量和脑功能评估的组合似乎比单独的肿瘤变量更好地预测生存。虽然在WBRT中添加MGd在治疗组之间没有产生显著的总体改善，但MGd可能改善肺癌脑转移患者的记忆和执行功能，并延长至神经认知和神经系统进展的时间。
PurposeTo report the neurocognitive findings in a phase III randomized trial evaluating survival and neurologic and neurocognitive function in patients with brain metastases from solid tumors receiving whole-brain radiation therapy (WBRT) with or without motexafin gadolinium (MGd).Patients and MethodsPatients were randomly assigned to receive WBRT30 Gy in 10 fractions with or without MGd 5 mg/kg/d. Monthly neurocognitive testing for memory, executive function, and tine motor skill was performed.ResultsFour hundred one patients were enrolled (251 with non-small-cell lung cancer, 75 with breast cancer, and 75 with other cancers); 90.5% patients had impairment of one or more neurocognitive tests at baseline. Neurocognitive test scores of memory, fine motor speed, executive function, and global neurocognitive impairment at baseline were correlated with brain tumor volume and predictive of survival. There was no statistically significant difference between treatment arms in time to neurocognitive progression. Patients with lung cancer (but not other types of cancer) who were treated with MGd tended to have improved memory and executive function (P =.062) and improved neurologic function as assessed by a blinded events review committee (P=.048).ConclusionNeurocognitive tests are a relatively sensitive measure of brain functioning; a combination of tumor prognostic variables and brain function assessments seems to predict survival better than tumor variables alone. Although the addition of MGd to WBRT did not produce a significant overall improvement between treatment arms, MGd may improve memory and executive function and prolong time to neurocognitive and neurologic progression in patients with brain metastases from lung cancer.