Neurocognitive functioning in patients with Cancer involving the central nervous system

Cancers of the central nervous system (CNS) include primary and metastatic tumors of varying cells of origin. These tumors may be benign or malignant, with incidence rates varying based on age, gender, and tumor type. While heterogeneous, all CNS tumors harbor risk of neurocognitive impairment, impairing patients' health-related quality of life (HRQoL).

This narrative review was informed by a targeted literature search in PubMed and Scopus, focusing on studies reporting neurocognitive deficits in patients with gliomas, primary CNS lymphomas, and metastatic CNS tumors. Articles were selected based on clinical relevance, methodological quality, and their contribution to key themes in neurocognitive outcomes among patients with CNS tumor: impact of tumor type, location, and treatment modalities, including surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. The influence of adjunctive treatments such as corticosteroids and antiepileptics on neurocognitive function was also examined. Data synthesis included neurocognitive assessment measures, patient demographics, and potential modifiers such as brain plasticity and psychological distress. This approach was designed to support an integrative, expert-informed synthesis rather than a systematic or exhaustive review.

Findings indicate that neurocognitive deficits are prevalent among CNS tumor patients, with impairments in memory, attention, processing speed, and executive function. Tumor location significantly influences the type and severity of deficits, with frontal and temporal lobe involvement being particularly detrimental. Treatment modalities contribute to neurocognitive decline, with radiotherapy having cumulative negative effects. Psychological distress and individual brain resilience further modulate outcomes, highlighting the need for individualized treatment strategies.

Neurocognitive impairment in CNS tumor patients results from both disease pathology and treatment effects. Understanding these mechanisms is crucial for developing targeted interventions, including cognitive rehabilitation and tailored treatment plans, to optimize patient outcomes. Improved management strategies incorporating neuroprotective approaches and psychological support are essential for enhancing long-term HRQoL in CNS tumor patients.