People who experience side effects from cranial radiation therapy may recover full neurocognitive function within months

Medical Xpress / American Society for Radiation Oncology (ASTRO) Annual Meeting ^ | Sept. 29, 2024 | Hua-Ren Ryan Cherng, MD et al

[ConservativeMind]

A substantial number of patients with brain metastases who experience cognitive side effects following radiation therapy may fully regain cognitive function, according to a pooled analysis of three large, Phase III clinical trials.

Recovery was more likely for people treated with conformal, or highly targeted, radiation techniques, compared to standard whole-brain treatment.

The two most common types of conformal radiation are stereotactic radiosurgery (SRS), which delivers fewer, but higher doses of radiation per treatment to the tumor site, and hippocampal avoidance WBRT, which limits radiation exposure to the parts of the brain known to contribute to neurocognitive side effects that occur following treatment. Conformal radiation techniques have been shown in previous research to cause fewer cognitive side effects than traditional WBRT.

Six months following the first signs of cognitive decline, 38% of patients experienced full cognitive recovery, rising to 42% of patients at one year.

And although not all patients made a full recovery, roughly three-fourths recovered at least some lost cognitive function. Six months after treatment, 73% demonstrated improvement on one or more cognitive tests, rising to 76% at 12 months. Among the subset of patients who continued cognitive testing for two years of follow-up (n=65), two-thirds demonstrated sustained cognitive recovery.

Patients treated with conformal radiation techniques were significantly more likely to demonstrate full cognitive recovery. The cumulative incidence of full cognitive recovery was higher among patients who received SRS compared to WBRT (HR 2.68, p=0.002) and those who received SRS alone compared to SRS with WBRT (HR 2.35, p=0.008).

There was also a nearly significant trend toward greater likelihood of cognitive recovery among people who received WBRT with hippocampal avoidance, compared to people who received WBRT alone (HR 1.57, p=0.059).

[ConservativeMind]

It appears you can get your full thinking ability back, despite radiation treatment to the brain. They found stereotactic radiosurgery (SRS) alone was best, though.

This is better than I would have expected.

[ConservativeMind]

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[Openurmind]

My wife got back about over 95% before it declined again and the cancer finally consumed her brain.