Clinical patterns and biological correlates of cognitive dysfunction associated with cancer therapy

J Dietrich, M Monje, J Wefel, C Meyers - The oncologist, 2008 - academic.oup.com
J Dietrich, M Monje, J Wefel, C Meyers
The oncologist, 2008academic.oup.com
Abstract Learning Objectives After completing this course, the reader should be able to:
Assess the common symptoms of central nervous system toxicity seen in patients treated
with chemotherapy and cranial radiation. Diagnose the patterns of cognitive dysfunction
encountered in patients treated for cancer. Evaluate cranial imaging abnormalities
consistent with nervous system toxicity from cancer therapy. Explain the novel concepts of
the cell-biological consequences underlying chemotherapy-and radiation therapy …
Learning Objectives
After completing this course, the reader should be able to:
  • Assess the common symptoms of central nervous system toxicity seen in patients treated with chemotherapy and cranial radiation.
  • Diagnose the patterns of cognitive dysfunction encountered in patients treated for cancer.
  • Evaluate cranial imaging abnormalities consistent with nervous system toxicity from cancer therapy.
  • Explain the novel concepts of the cell-biological consequences underlying chemotherapy- and radiation therapy–associated nervous system toxicity.
CME This article is available for continuing medical education credit at CME.TheOncologist.com
Standard oncological therapies, such as chemotherapy and cranial radiotherapy, frequently result in a spectrum of neurocognitive deficits that includes impaired learning, memory, attention, and speed of information processing. In addition to classical mechanisms of neurotoxicity associated with chemo- and radiotherapy, such as radiation necrosis and leukoencephalopathy, damage to dynamic progenitor cell populations in the brain is emerging as an important etiologic factor. Radiation- and chemotherapy-induced damage to progenitor populations responsible for maintenance of white matter integrity and adult hippocampal neurogenesis is now believed to play a major role in the neurocognitive impairment many cancer survivors experience.
Oxford University Press