The Clinical Study of the Effect of WBRT on Cognitive Function of Patients With Brain Metastasis of Lung Cancer

Abstract

To explore the influence of WBRT on cognitive function and activities of daily life of patients with brain metastasis of lung cancer.102 lung cancer patients with brain metastases (BM) group and 41 lung cancer patients with non-brain metastases (NBM) group were selected as the objects from January 2014 to December 2016. MoCA and MMSE were used to assess the cognitive function of the patients; ADCS-ADL was used to assess the activities of daily living of the patients; CT and/or MRI were used to determine the characteristics of the patients with intracranial tumors. A statistical software was used to analyze the correlation between the characteristics of intracranial lesions and the level of cognitive function in patients with brain metastasis of lung cancer.The proportion of patients with cognitive impairment in BM group was higher than that in NBM group, and the difference was statistically significant (P < 0.05); the MoCA scores and MMSE scores in BM group were lower than that in NMB group and the difference was statistically significant (all P < 0.05). The pathological classification of lung cancer could affect the cognitive function of patients assessed by MoCA (P = 0.010) but not by MMSE (P = 0.123). There was no significant correlation between the volume of brain metastases, the volume of total edema zone, the number of involved lobes and the level of cognitive function in patients with brain metastases from lung cancer before WBRT (P > 0.05), but there was a positive correlation between the number of brain metastases and the level of cognitive function in patients with brain metastases from lung cancer before WBRT (all P < 0.05), negatively correlated with MoCA and MMSE scores (all P < 0.05). There were significant differences in cognitive function (MoCA scores and MMSE scores) among the groups with brain metastasis involving different hemispheres (all P < 0.05). The cognitive function level of patients with more than 3 brain metastases was significantly lower than that of patients with less than 3 brain metastases (both P < 0.05). After WBRT, the cognitive function of patients with brain metastases from lung cancer was improved by MoCA (P = 0.003) but not by MMSE (P = 0.370). There was significant difference in the total scores of MOCA and MMSE in the cognitive function scores of the patients assessed three months after radiotherapy compared with that before radiotherapy. The scores of 6 months after radiotherapy were significantly improved. The ADCS-ADL scores of the two groups before and after WBRT were statistically significant (P = 0.028).Before WBRT, most of the patients with brain metastasis of lung cancer have different degrees of cognitive impairment, among which MCI was the main one. The overall cognitive function and activities of daily living of patients with brain metastasis from lung cancer can be improved after 6 months of WBRT. MoCA is more sensitive than MMSE in the screening of cognitive impairment in patients with brain metastasis of lung cancer.Y. Lian: None. Y. Tian: None.