Neurocognitive function (NCF) in patients (pts) treated with chemo/bio-radiotherapy (C/B-RT) for head and neck cancers (HNC).

Abstract

5522 Background: There is evidence that cancer and/or its treatment can impair thinking abilities. To date, there have been no longitudinal studies exploring NCF in HNC pts. We present a prospective NCF assessment in HNC pts treated with C/B-RT. Methods: Baseline information including pt demographics, primary tumor site, stage, smoking/alcohol history, systemic therapy details and RT dosimetry were collected. All pts underwent a 2-hour battery of NCF testing at baseline and at 1-year (yr). Domains evaluated included memory, motor skills, intelligence, language, attention, processing speed and executive function (EF). Performances on the various tests were transformed to Z-scores using normative data. NCF decline was defined as a Z-score decrease of ≥-1 and improvement as a Z-score increase of ≥+1. Pts also had subjective assessments of anxiety, depression, NCF and quality of life (QOL) using the Hospital Anxiety and Depression Scale and FACT questionnaires. QOL was considered significantly altered if FACT score changes were ≥ +10 (improvement) / -10 (decline). Results: Pt demographics (n= 24) were M:F= 19:5, mean age= 61.2, CRT(cisplatin):BRT(panitumumab):RT= 14:6:4, oropharynx:other= 21:3. At 1-yr, 6 pts (25%) had NCF decline in at least one cognitive domain, with memory and attention being most frequently affected (n= 3 each). Three of 6 pts with NCF decline had multiple domains affected, most frequently in memory, attention and EF. One pt with NCF declines in intelligence, memory and attention received the highest RT dose to the frontal and temporal lobes. Five pts had NCF improvements, albeit only in a single domain each. Although 96% of pts did not report severe levels of anxiety or depression, more pts subjectively reported lower NCF (46%) and QOL (33%) than those reporting higher NCF or QOL (17% and 8% respectively) at 1-yr. There was no clear association between changes in objective NCF and changes in subjective NCF or QOL. Conclusions: C/B-RT in HNC pts may be associated with NCF decline at 1-yr and can affect multiple domains. Subjective declines in NCF and QOL were more frequent than objective NCF declines. Longer-term follow up is underway to further characterize these findings.