NEUROPSYCHOLOGICAL EFFECTS OF PROPHYLACTIC CRANIAL IRRADIATION (PCI) IN ADULT CANCER-PATIENTS

Prophylactic cranial irradiation (PCI) has led to marked prolongation of survival, but also to intellectual and neuropsychological retardati on in children with ALL. PCI has also been conducted in adult patients with small-cell bronchial carcinoma in the stage of minimal disease o r with breast cancer. There are no studies assessing cognitive or othe r neuropsychological consequences of PCI in adult cancer patients. We report on a longitudinal prospective study of the effects of PCI on fi ve major neuropsychological domains (intelligence, concentration, atte ntion, memory and psychomotor performance). We report on our ongoing s tudy, in which up to now 11 patients with small-cell lung cancer under going PCI have been investigated. Patients are assessed immediately be fore therapy started as well as 4 weeks and 3 months after onset of PC I. The used instruments are Standard Progressive Matrices (SPM), d2 Co ncentration Test, Minimental State, Verbal Learning Test and Psychomot or Tests (Steadiness, Aiming, Tapping, Tracking, Pursuit Rotor Test). Although our sample is small, results indicate that there is no eviden ce for a decrease in neuropsychological abilities in adults after thre e months. This is in contrast to the observed results after PCI in chi ldren. As compared to baseline measures, differences in memory, intell igence, concentration and attention were marginal over time. Moreover the progress of motor performance skills showed no clear tendency.