Neurocognitive Functioning in Glioblastoma Multiforme Patients during Radiotherapy Plus Concomitant and Adjuvant Temozolomide: A Case Series
Abstract
Background: Glioblastoma Multiforme (GBM) belongs to the most aggressive brain tumours with limited therapeutic options. In the clinical presentation often dominate the mental changes (memory loss, impaired speech, changes in personality and temperament).
The authors evaluate in a pilot study the neurocognitive function of patients with GBM. Patients and Methods: The evaluation of neurocognitive function had been performed during 2009-2010 in eleven patients with GBM (9 women, 2 men) with a mean age of 56.8 years (age range 45-72).
The assessment of neurocognitive functions was performed by clinical neuropsychologist using the methods sensitive for cognitive deficit. Results: Because of a limited set of patients and an insufficient number of schedule check-ups (caused by severe tumour progression) the results could not be statistically evaluated.
Due to these circumstances, the results of a pilot project are presented in the form of a case series. There are presented the results of three patients with different localization of GBM and with different type of neurosurgical intervention (total resection, subtotal resection and stereotactic biopsy).
Conclusion: The diagnosis of cognitive deficit can be based on careful assessment of personal medici history, present symptoms and physical examination. Laboratory tests and paging technique help by the detection of secondary cognitive changes.
Targeted examination of cognitive function relies in use of various neuropsychological tests. To monitor developments and changes in cognitive functions in patients with GBM the following battery of neuropsychological tests has shown helpful information: Addenbrooke's Cognitive Examination, Trail Making Test, Rey-Osterrieth Complex Figure and Verbal Fluency Test.
It seems that this battery of neuropsychological tests is suitable for repeated long-term monitoring of cognitive function in cancer patients undergoing radiotherapy of brain.