The association of health-related quality of life and cognitive function in patients receiving memantine for the prevention of cognitive dysfunction during whole-brain radiotherapy

Nadia N. Laack, Stephanie L. Pugh, Paul D. Brown, Sherry Fox, Jeffrey S. Wefel, Christina Meyers, Ali Choucair, Deepak Khuntia, John H. Suh, David Roberge, Merideth M. Wendland, Deborah Bruner

Research output: Contribution to journalArticle

Abstract

Background: This study evaluated the association between health-related quality of life (HRQOL) and cognition in patients receiving memantine for prevention of cognitive dysfunction during whole-brain radiotherapy (WBRT). Methods: Adult patients with brain metastases received WBRT and were randomized to receive placebo or memantine, 20 mg per day, within 3 days of initiating radiotherapy, for 24 weeks. The Functional Assessment of Cancer Therapy-Brain module (FACT-Br) and Medical Outcomes Scale-Cognitive Functioning Scale (MOS-C) were completed in coordination with serial standardized tests of cognitive function. Results: Of the 508 eligible patients, 442 (87%) consented to participate in the HRQOL portion and contributed to baseline analyses. Evaluable patients at 24 weeks (n = 246) included surviving patients completing FACT-Br, MOS-C, and objective cognitive assessments (n = 146, 59%) and patients alive at time of missed assessment (n = 100, 41%). Baseline cognitive function correlated significantly with FACT-Br and MOS-C self-reports. All domains of objective cognitive function showed declines over time. Neither FACT-Br nor MOS-C differed between the treatment arms. Emotional and functional well-being subscales of the FACT improved over time while the remainder of the FACT-Br domains remained stable. MOS-C scores declined over time. Conclusion: Baseline cognitive function correlated significantly with FACT-Br and MOS-C scores. No by-Arm differences in HRQOL were observed despite differences in objective cognitive function. Patient attrition and poor testing compliance remain significant problems in studies of cognitive function of brain metastases patients and further effort is needed to improve compliance with testing and sensitivity of patient-reported measures.

Original languageEnglish (US)
Article numbernpy038
Pages (from-to)274-282
Number of pages9
JournalNeuro-Oncology Practice
Volume6
Issue number4
DOIs
StatePublished - Jul 27 2019

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Memantine
Cognition
Radiotherapy
Quality of Life
Brain Neoplasms
Brain
Therapeutics
Neoplasm Metastasis
Cognitive Dysfunction
Self Report
Compliance
Placebos

Keywords

  • brain metastases
  • quality of life
  • radiotherapy

ASJC Scopus subject areas

  • Medicine (miscellaneous)

Cite this

The association of health-related quality of life and cognitive function in patients receiving memantine for the prevention of cognitive dysfunction during whole-brain radiotherapy. / Laack, Nadia N.; Pugh, Stephanie L.; Brown, Paul D.; Fox, Sherry; Wefel, Jeffrey S.; Meyers, Christina; Choucair, Ali; Khuntia, Deepak; Suh, John H.; Roberge, David; Wendland, Merideth M.; Bruner, Deborah.

In: Neuro-Oncology Practice, Vol. 6, No. 4, npy038, 27.07.2019, p. 274-282.

Research output: Contribution to journalArticle

Laack, NN, Pugh, SL, Brown, PD, Fox, S, Wefel, JS, Meyers, C, Choucair, A, Khuntia, D, Suh, JH, Roberge, D, Wendland, MM & Bruner, D 2019, 'The association of health-related quality of life and cognitive function in patients receiving memantine for the prevention of cognitive dysfunction during whole-brain radiotherapy', Neuro-Oncology Practice, vol. 6, no. 4, npy038, pp. 274-282. https://doi.org/10.1093/nop/npy038
Laack, Nadia N. ; Pugh, Stephanie L. ; Brown, Paul D. ; Fox, Sherry ; Wefel, Jeffrey S. ; Meyers, Christina ; Choucair, Ali ; Khuntia, Deepak ; Suh, John H. ; Roberge, David ; Wendland, Merideth M. ; Bruner, Deborah. / The association of health-related quality of life and cognitive function in patients receiving memantine for the prevention of cognitive dysfunction during whole-brain radiotherapy. In: Neuro-Oncology Practice. 2019 ; Vol. 6, No. 4. pp. 274-282.
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abstract = "Background: This study evaluated the association between health-related quality of life (HRQOL) and cognition in patients receiving memantine for prevention of cognitive dysfunction during whole-brain radiotherapy (WBRT). Methods: Adult patients with brain metastases received WBRT and were randomized to receive placebo or memantine, 20 mg per day, within 3 days of initiating radiotherapy, for 24 weeks. The Functional Assessment of Cancer Therapy-Brain module (FACT-Br) and Medical Outcomes Scale-Cognitive Functioning Scale (MOS-C) were completed in coordination with serial standardized tests of cognitive function. Results: Of the 508 eligible patients, 442 (87{\%}) consented to participate in the HRQOL portion and contributed to baseline analyses. Evaluable patients at 24 weeks (n = 246) included surviving patients completing FACT-Br, MOS-C, and objective cognitive assessments (n = 146, 59{\%}) and patients alive at time of missed assessment (n = 100, 41{\%}). Baseline cognitive function correlated significantly with FACT-Br and MOS-C self-reports. All domains of objective cognitive function showed declines over time. Neither FACT-Br nor MOS-C differed between the treatment arms. Emotional and functional well-being subscales of the FACT improved over time while the remainder of the FACT-Br domains remained stable. MOS-C scores declined over time. Conclusion: Baseline cognitive function correlated significantly with FACT-Br and MOS-C scores. No by-Arm differences in HRQOL were observed despite differences in objective cognitive function. Patient attrition and poor testing compliance remain significant problems in studies of cognitive function of brain metastases patients and further effort is needed to improve compliance with testing and sensitivity of patient-reported measures.",
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AU - Pugh, Stephanie L.

AU - Brown, Paul D.

AU - Fox, Sherry

AU - Wefel, Jeffrey S.

AU - Meyers, Christina

AU - Choucair, Ali

AU - Khuntia, Deepak

AU - Suh, John H.

AU - Roberge, David

AU - Wendland, Merideth M.

AU - Bruner, Deborah

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N2 - Background: This study evaluated the association between health-related quality of life (HRQOL) and cognition in patients receiving memantine for prevention of cognitive dysfunction during whole-brain radiotherapy (WBRT). Methods: Adult patients with brain metastases received WBRT and were randomized to receive placebo or memantine, 20 mg per day, within 3 days of initiating radiotherapy, for 24 weeks. The Functional Assessment of Cancer Therapy-Brain module (FACT-Br) and Medical Outcomes Scale-Cognitive Functioning Scale (MOS-C) were completed in coordination with serial standardized tests of cognitive function. Results: Of the 508 eligible patients, 442 (87%) consented to participate in the HRQOL portion and contributed to baseline analyses. Evaluable patients at 24 weeks (n = 246) included surviving patients completing FACT-Br, MOS-C, and objective cognitive assessments (n = 146, 59%) and patients alive at time of missed assessment (n = 100, 41%). Baseline cognitive function correlated significantly with FACT-Br and MOS-C self-reports. All domains of objective cognitive function showed declines over time. Neither FACT-Br nor MOS-C differed between the treatment arms. Emotional and functional well-being subscales of the FACT improved over time while the remainder of the FACT-Br domains remained stable. MOS-C scores declined over time. Conclusion: Baseline cognitive function correlated significantly with FACT-Br and MOS-C scores. No by-Arm differences in HRQOL were observed despite differences in objective cognitive function. Patient attrition and poor testing compliance remain significant problems in studies of cognitive function of brain metastases patients and further effort is needed to improve compliance with testing and sensitivity of patient-reported measures.

AB - Background: This study evaluated the association between health-related quality of life (HRQOL) and cognition in patients receiving memantine for prevention of cognitive dysfunction during whole-brain radiotherapy (WBRT). Methods: Adult patients with brain metastases received WBRT and were randomized to receive placebo or memantine, 20 mg per day, within 3 days of initiating radiotherapy, for 24 weeks. The Functional Assessment of Cancer Therapy-Brain module (FACT-Br) and Medical Outcomes Scale-Cognitive Functioning Scale (MOS-C) were completed in coordination with serial standardized tests of cognitive function. Results: Of the 508 eligible patients, 442 (87%) consented to participate in the HRQOL portion and contributed to baseline analyses. Evaluable patients at 24 weeks (n = 246) included surviving patients completing FACT-Br, MOS-C, and objective cognitive assessments (n = 146, 59%) and patients alive at time of missed assessment (n = 100, 41%). Baseline cognitive function correlated significantly with FACT-Br and MOS-C self-reports. All domains of objective cognitive function showed declines over time. Neither FACT-Br nor MOS-C differed between the treatment arms. Emotional and functional well-being subscales of the FACT improved over time while the remainder of the FACT-Br domains remained stable. MOS-C scores declined over time. Conclusion: Baseline cognitive function correlated significantly with FACT-Br and MOS-C scores. No by-Arm differences in HRQOL were observed despite differences in objective cognitive function. Patient attrition and poor testing compliance remain significant problems in studies of cognitive function of brain metastases patients and further effort is needed to improve compliance with testing and sensitivity of patient-reported measures.

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