Neurological and cognitive impairment in long-term survivors of small cell lung cancer.

2.50
Hdl Handle:
http://hdl.handle.net/10541/97294
Title:
Neurological and cognitive impairment in long-term survivors of small cell lung cancer.
Authors:
Cull, A; Gregor, A; Hopwood, Penelope; Macbeth, F; Karnicka-Mlodkowska, H; Thatcher, Nick; Burt, Paul A; Stout, Ronald; Stepniewska, K; Stewart, M
Abstract:
Despite its effectiveness in reducing the rate of brain metastases, the role of prophylactic cranial irradiation (PCI) in the management of small cell lung cancer (SCLC) remains controversial because of concern about radiation-induced neurological morbidity. In order to evaluate morbidity and its impact on quality of life 64 patients surviving > or = 2 years in remission were recalled for assessment. 52 had received PCI. Most of the patients were well: 95% had performance status < or = 1 and nine out of 37 neurological examinations were abnormal. On neuropsychometric testing, only 19% of patients performed at the level expected for their age and intellectual ability on all four tests used. Fifty-four per cent of patients were impaired on two or more of the tests, suggesting a significant degree of measurable cognitive dysfunction. The number of patients who had not received PCI was insufficient for comparative analysis with the number who had, but among those treated with PCI, patients receiving 8 Gy in 1 fraction appeared less impaired than those receiving higher radiation doses in multiple fractions. The study showed that neuropsychometric testing is acceptable to patients, can be administered by non-psychologists in the clinic and is sensitive to otherwise undetected deficits of cognitive function in this patient population. Prospective evaluation of PCI should include neuropsychometric testing.
Affiliation:
ICRF Medical Oncology Unit, Western General Hospital, Edinburgh, U.K.
Citation:
Neurological and cognitive impairment in long-term survivors of small cell lung cancer. 1994, 30A (8):1067-74 Eur. J. Cancer
Journal:
European Journal of Cancer
Issue Date:
1994
URI:
http://hdl.handle.net/10541/97294
DOI:
10.1016/0959-8049(94)90458-8
PubMed ID:
7654431
Type:
Article
Language:
en
ISSN:
0959-8049
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorCull, Aen
dc.contributor.authorGregor, Aen
dc.contributor.authorHopwood, Penelopeen
dc.contributor.authorMacbeth, Fen
dc.contributor.authorKarnicka-Mlodkowska, Hen
dc.contributor.authorThatcher, Nicken
dc.contributor.authorBurt, Paul Aen
dc.contributor.authorStout, Ronalden
dc.contributor.authorStepniewska, Ken
dc.contributor.authorStewart, Men
dc.date.accessioned2010-04-23T11:41:00Z-
dc.date.available2010-04-23T11:41:00Z-
dc.date.issued1994-
dc.identifier.citationNeurological and cognitive impairment in long-term survivors of small cell lung cancer. 1994, 30A (8):1067-74 Eur. J. Canceren
dc.identifier.issn0959-8049-
dc.identifier.pmid7654431-
dc.identifier.doi10.1016/0959-8049(94)90458-8-
dc.identifier.urihttp://hdl.handle.net/10541/97294-
dc.description.abstractDespite its effectiveness in reducing the rate of brain metastases, the role of prophylactic cranial irradiation (PCI) in the management of small cell lung cancer (SCLC) remains controversial because of concern about radiation-induced neurological morbidity. In order to evaluate morbidity and its impact on quality of life 64 patients surviving > or = 2 years in remission were recalled for assessment. 52 had received PCI. Most of the patients were well: 95% had performance status < or = 1 and nine out of 37 neurological examinations were abnormal. On neuropsychometric testing, only 19% of patients performed at the level expected for their age and intellectual ability on all four tests used. Fifty-four per cent of patients were impaired on two or more of the tests, suggesting a significant degree of measurable cognitive dysfunction. The number of patients who had not received PCI was insufficient for comparative analysis with the number who had, but among those treated with PCI, patients receiving 8 Gy in 1 fraction appeared less impaired than those receiving higher radiation doses in multiple fractions. The study showed that neuropsychometric testing is acceptable to patients, can be administered by non-psychologists in the clinic and is sensitive to otherwise undetected deficits of cognitive function in this patient population. Prospective evaluation of PCI should include neuropsychometric testing.en
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshBrain Diseases-
dc.subject.meshCarcinoma, Small Cell-
dc.subject.meshCognition Disorders-
dc.subject.meshCranial Irradiation-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshLung Neoplasms-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshQuality of Life-
dc.subject.meshSurvivors-
dc.titleNeurological and cognitive impairment in long-term survivors of small cell lung cancer.en
dc.typeArticleen
dc.contributor.departmentICRF Medical Oncology Unit, Western General Hospital, Edinburgh, U.K.en
dc.identifier.journalEuropean Journal of Canceren

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