Assessment of Neurocognitive Functioning in Clinical Practice and for Trial Purposes

Abstract

Patient-oriented outcome measures, such as symptoms, physical functioning, and health-related quality of life, are pertinent outcome measures for patients who cannot be cured of their disease. This is the case for virtually all patients with primary or metastatic brain tumors for whom palliation of symptoms and the maintenance or improvement of health-related quality of life are important goals of treatment earlier or later in the disease trajectory. Brain tumors greatly impact on an individual, as well as their family members and friends. The tumor or its treatment (i.e., chemotherapy, radiation, pharmacological treatment) may directly or indirectly cause neurological impairments that affect the physical, social, vocational, and emotional capabilities of the individual. The available treatment options for both primary and metastatic brain tumors have improved and brought with them modest improved patient survival. Evaluation of treatment in brain tumor patients should therefore not only focus on survival improvement, but should also aim at determining neurological functioning and adverse treatment effects on the normal brain. In this respect, neurocognitive functioning (NCF) is a highly critical outcome measure for brain tumor patients [1]. Apart from a prognostic significance of baseline NCF [2, 3], deterioration in NCF in brain tumor patients may herald tumor progression, even before signs of disease recurrence are evident on CT or MRI [4–6].