Just a bad memory.

Top Line: Does radiation have detrimental cognitive effects compared to chemo alone for low grade glioma?

The Study: Radiation plays an important role in the treatment of low-grade glioma. However, some question whether the negative neurocognitive effects of radiation might outweigh the benefits of radiation. The problem is that sentiment is largely an assumption without strong supporting data. The EORTC 22033-26033 trial compared radiation alone and temozolomide alone for high risk, low grade glioma and found no significant difference in median PFS. In this report, patients from the trial underwent cognitive testing using the Visual Verbal Learning Test (VVLT) every 6 months after treatment to compare memory changes after treatment. A challenge with the study’s long-term neurocognitive testing was that compliance dropped significantly after a year. But over the first year, there was no significant difference in neurocognitive outcomes between arms. In addition, this recent systematic review identified 11 studies evaluating the cognitive effects of radiation for LGG. These studies found either negative or contradictory results, and there was no strong data to support an independent, detrimental effect of radiation on cognition among patients treated for LGG.

TBL: There is no strong data to support negative cognitive effects of radiation compared to other treatments in the management of low grade glioma. | Klein, Neuro-Oncol 2021 and Koutsarnakis, Radiother Oncol 2021