Radiotherapy Adds to Impairment Associated with Gliomas

Dutch researchers have discovered that while most of the cognitive impairment associated with gliomas is caused by the tumor, high-dose radiotherapy can worsen the impairment and may not improve survival. Their findings were reported in the November 2, 2002, issue of The Lancet.

The researchers compared 195 low-grade glioma patients, including 104 who had received radiotherapy, with 100 patients suffering from low-grade hematologic cancers and with 195 normal controls. They found lower cognitive functioning in the glioma patients when they were compared with hematologic patients and found still lower cognitive functioning when the glioma patients were compared to the normal controls. Radiotherapy was found to be linked to poorer cognitive functioning. Disability in the memory domain, however, was noted only in those patients who had been given radiation doses greater than 2 Gy.

Because early radiotherapy does not improve survival in low-grade glioma and might contribute to increased cognitive deficits, it should not be used in asymptomatic patients, according to Dr. Martin Klein, of Vrije University Medical Center (Amsterdam, The Netherlands), who led the study. If it is used, Dr. Klein recommends that fraction doses not exceed 2 Gy.




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