Central Nervous System

PV QA 2 - Poster Viewing Q&A 2

MO_1_2487 - Assessing the Impact of Pre-Treatment White Matter Hyperintensities on Cognitive Function After Whole Brain Radiation Therapy (WBRT)

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Assessing the Impact of Pre-Treatment White Matter Hyperintensities on Cognitive Function After Whole Brain Radiation Therapy (WBRT)
M. Chan1,2, D. Ferguson3, E. Ni Mhurchu3, R. Yuan3, D. Li1, G. Lovedeep3, and A. Nichol3; 1University of British Columbia, Vancouver, BC, Canada, 2BC Cancer, Vancouver, BC, Canada, 3BC Cancer Agency, Vancouver, BC, Canada

Purpose/Objective(s): Our study aim was to assess whether pre-treatment white matter hyperintensities (WMH) would be associated with worse cognitive outcomes after WBRT in patients with brain metastases previously enrolled in a clinical trial (NCT01046123).

Materials/Methods: Forty-one patients treated with WBRT and radiosurgery had suitable pre-treatment MRIs, as well as serial Montreal Cognitive Assessments (MoCA) and Mini-Mental State Examinations (MMSE) after radiotherapy. Baseline T2-weighted fluid attenuation inverse recovery (FLAIR) imaging was independently assessed by 2 neuroradiologists for the presence of deep (dWMH) and periventricular (pvWMH) WMH using the Fazekas visual rating scale. WMH volumes were also manually contoured on the baseline T2 FLAIR imaging. For all analyses, patients were censored at the time of radionecrosis or progression of brain metastasis. Descriptive statistics and logistic regression modeling were used to investigate the relationship between WMH and cognitive scores.

Results: For a dWMH Fazekas score of 1-3 versus 0, there was a median drop of 3 points in total MoCA score between baseline and the lowest score at any time point. A 1.5-point median drop in MoCA score was also seen between baseline and last cognitive testing date. For pvWMH Fazekas scores of 2-3 versus 0-1, there was a median drop of 1 point in MoCA score between baseline and the lowest score at any time point. A 3-point median drop in MoCA score was seen between baseline and last cognitive testing date. These trends towards worse cognitive outcomes with increasing WMH were also seen in MMSE scores and in our analysis using the WMH volumes. Using logistic regression modeling, a non-significant increased risk of MoCA decline was associated with the presence of either dWMH (OR 2.20; 95% CI 0.57-8.6; p = 0.25) or pvWMH (OR 3.73; 95% CI 0.67-20.7; p = 0.13).

Conclusion: This small hypothesis-generating study outlines a methodology for investigating whether pre-treatment WMH is a risk factor for worse cognitive outcome after whole brain radiotherapy.

Author Disclosure: M. Chan: None. D. Ferguson: None. E. Ni Mhurchu: None. D. Li: None. A. Nichol: None.

Send Email for Matthew Chan


Assets

MO_1_2487 - Assessing the Impact of Pre-Treatment White Matter Hyperintensities on Cognitive Function After Whole Brain Radiation Therapy (WBRT)



Attendees who have favorited this

Please enter your access key

The asset you are trying to access is locked. Please enter your access key to unlock.

Send Email for Assessing the Impact of Pre-Treatment White Matter Hyperintensities on Cognitive Function After Whole Brain Radiation Therapy (WBRT)