UBC Faculty Research and Publications

Patients with pretreatment leukoencephalopathy and older patients have more cognitive decline after whole brain radiotherapy Chan, Matthew; Ferguson, David; Ni Mhurchu, Elaine; Yuan, Ren; Gondara, Lovedeep; McKenzie, Michael; Olson, Robert; Thiessen, Brian; Lalani, Nafisha; Ma, Roy; Nichol, Alan

Abstract

Purpose: To investigate predictors of cognitive decline after whole brain radiotherapy (WBRT) for brain metastases. Methods: A secondary analysis of a phase 2 clinical trial was conducted in patients who received stereotactic radiosurgery for 1–10 brain metastases and WBRT (NCT01046123). The Montreal Cognitive Assessment (MoCA) was performed at baseline and every 3 months after WBRT. Baseline T2-weighted fluid attenuation inversion recovery magnetic resonance imaging was independently assessed by two neuroradiologists for the presence of white matter hyperintensities (WMH) using the Fazekas visual rating scale. WMH were also manually segmented for volumetric analysis. Univariable and multivariable logistic regression were used to test the association between baseline variables and MoCA score decline. Results: Forty-six patients survived ≥ 3 months after treatment. Age (OR 1.12 (1.04–1.21), p 

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