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Brain metastases and treatment: multiplying cognitive toxicities
Elise F Nassif1, Alexandre Arsène-Henry1, Youlia M Kirova1
1a Department of Radiotherapy , Institut Curie , Paris , France.
Expert Review of Anticancer Therapy
|February 14, 2019
Summary
Cancer treatments for brain metastases can cause cognitive impairment, significantly impacting quality of life. Tailoring treatments and standardizing assessments are crucial for managing this toxicity.
Area of Science:
- Neuro-oncology
- Cancer Treatment Toxicity
Background:
- Brain metastases affect 30% of cancer patients.
- Cancer treatments, including surgery, radiotherapy, chemotherapy, targeted therapies, immunotherapies, and hormone therapy, are used for CNS disease.
- Cognitive impairment is a common and quality-of-life-limiting toxicity of these treatments.
Purpose of the Study:
- To review the role of various cancer treatments in cognitive decline for patients with brain metastases.
- To discuss pathological and molecular mechanisms underlying treatment-induced cognitive toxicity.
- To explore future directions for mitigating cognitive side effects and refine benefit-risk assessments.
Main Methods:
- Literature review of cancer treatments (surgery, radiotherapy, chemotherapy, targeted therapies, immunotherapies, hormone therapy).
- Analysis of pathological and molecular mechanisms of cognitive impairment.
- Discussion of other causes of cognitive dysfunction in brain metastasis patients.
Main Results:
- Cancer treatments are associated with significant cognitive toxicities.
- Understanding mechanisms and other contributing factors is key to managing cognitive decline.
- Tailored treatment strategies and standardized cognitive assessments are needed.
Conclusions:
- Cumulative cognitive toxicity must be considered alongside survival benefits.
- Personalized treatment approaches are essential for patients with brain metastases.
- Standardized cognitive assessments are necessary to accurately evaluate treatment-related effects.
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