Cancer Control Research
5R03CA083351-02
Correa, Denise D.
COGNITIVE FUNCTIONING AND QUALITY OF LIFE IN CNS LYMPHOM
Abstract
DESCRIPTION: (Applicant's Description)
The incidence of primary central nervous system lymphoma (PCNSL) has increased
threefold in immunocompetent populations in recent years. Improvements in
treatment, particularly involving combined modality therapy with chemotherapy
and radiotherapy have been shown to augment patient survival with a median
disease-free period of about 40 months. However, the combination of these two
modalities often increases the risk for delayed neurotoxicity. There is a
paucity of studies that have assessed neuropsychological functioning and
quality of life in patients with PCNSL. The majority of studies reported
performance status and survival rates, but systematic cognitive evaluations
were only seldom included. Unfortunately, relying only on these variables
does not adequately assess the more subtle cognitive impairments that most
patients with brain tumors experience. Neuropsychological difficulties often
interfere with disease-free patients' ability to function at premorbid levels
at work and at home. A study including neuropsychological evaluations of a
relatively large group of patients with PCNSL who received combined modality
treatments and are in remission from their disease is planned. A follow-up
assessment also will be performed in order to monitor performance over a
specified period of time. Research in order to better understand the
incidence, extent, and severity of treatment-induced neuropsychological
impairments in patients with PCNSL is of utmost importance, given the recent
increase in both the number of cases diagnosed and long-term survival. It is
likely to provide valuable information regarding specific areas that should be
addressed in the development of strategies for cognitive rehabilitation or
other interventions that may be appropriate. The findings of this study will
also be relevant for comparison with ongoing and future research investigating
the potential neurocognitive sequelae of alternative treatment modalities for
PCNSL (e.g., high-dose chemotherapy followed by peripheral blood progenitor
cell (PBPC) transplant.)
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