Haripriya Parapparambil Surendran , Sujit Kumar Sah , Dhanya Mary Louis , Sruthi Kalavagunta , Narmadha Mukunthu Poornachary , Selin Chiriyankandath Joy , Debnarayan Dutta
{"title":"美金刚预防脑转移患者放射治疗引起的神经认知功能障碍的疗效：临床试验的系统综述。","authors":"Haripriya Parapparambil Surendran , Sujit Kumar Sah , Dhanya Mary Louis , Sruthi Kalavagunta , Narmadha Mukunthu Poornachary , Selin Chiriyankandath Joy , Debnarayan Dutta","doi":"10.1053/j.seminoncol.2023.09.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p><span><span>About 50%–90% of patients with brain metastases who receive radiation therapy experience </span>cognitive impairment. This </span>systematic review<span> aims to gather credible sources of comprehensive information on the efficacy of memantine in preventing cognitive dysfunction.</span></p></div><div><h3>Methods</h3><p>A comprehensive review conducted in compliance with the PRISMA statement and systematic search was performed across five databases included PubMed<sup>Ⓡ</sup><span>, Embase</span><sup>Ⓡ</sup><span>, Scopus</span><sup>Ⓡ</sup><span>, Cochrane Library</span><sup>Ⓡ</sup>, and ClinicalTrial.gov.in from inception until November 2021.</p></div><div><h3>Results</h3><p>A total of four eligible studies were selected in this review that included 1,444 patients with brain metastases who received radiation therapy (Intervention group [n = 729] and control group [n = 715]). Overall, three of the four studies reported some improvement in neurocognitive function in at least one or more parameters such as recall and recognition (<em>P</em> = .39, <em>P</em> = .10 and <em>P</em> = .05), verbal fluency (<em>P</em> = .03 and <em>P</em> < .0001), complex attention (<em>P</em> = .59) executive function (<em>P =</em> .92) and normal appearing white matter (<em>P</em><span> = .01) following memantine therapy compared to control group. Further, two of the four studies reported an improvement in the patients’ quality of life following memantine therapy compared to the control group, and there was no significant difference in the toxicity profile of the interventional compared to the control group as reported from two studies.</span></p></div><div><h3>Conclusion</h3><p>This review embraces the comprehensive evidence that the use of memantine therapy in patients<span><span> with brain metastases to prevent radiation-induced neurocognitive dysfunction has a modest and statistically significant beneficial impact in improving quality of life and preserving some neurocognitive function without any complications. Pending the completion of additional ongoing studies, one can argue that memantine is a reasonable treatment to consider in patients with brain metastases while they receive </span>whole brain radiation therapy.</span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"50 3","pages":"Pages 113-122"},"PeriodicalIF":3.0000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of memantine in preventing neurocognitive dysfunction induced by radiation therapy in patients with brain metastases: A systematic review of clinical trials\",\"authors\":\"Haripriya Parapparambil Surendran , Sujit Kumar Sah , Dhanya Mary Louis , Sruthi Kalavagunta , Narmadha Mukunthu Poornachary , Selin Chiriyankandath Joy , Debnarayan Dutta\",\"doi\":\"10.1053/j.seminoncol.2023.09.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p><span><span>About 50%–90% of patients with brain metastases who receive radiation therapy experience </span>cognitive impairment. This </span>systematic review<span> aims to gather credible sources of comprehensive information on the efficacy of memantine in preventing cognitive dysfunction.</span></p></div><div><h3>Methods</h3><p>A comprehensive review conducted in compliance with the PRISMA statement and systematic search was performed across five databases included PubMed<sup>Ⓡ</sup><span>, Embase</span><sup>Ⓡ</sup><span>, Scopus</span><sup>Ⓡ</sup><span>, Cochrane Library</span><sup>Ⓡ</sup>, and ClinicalTrial.gov.in from inception until November 2021.</p></div><div><h3>Results</h3><p>A total of four eligible studies were selected in this review that included 1,444 patients with brain metastases who received radiation therapy (Intervention group [n = 729] and control group [n = 715]). Overall, three of the four studies reported some improvement in neurocognitive function in at least one or more parameters such as recall and recognition (<em>P</em> = .39, <em>P</em> = .10 and <em>P</em> = .05), verbal fluency (<em>P</em> = .03 and <em>P</em> < .0001), complex attention (<em>P</em> = .59) executive function (<em>P =</em> .92) and normal appearing white matter (<em>P</em><span> = .01) following memantine therapy compared to control group. Further, two of the four studies reported an improvement in the patients’ quality of life following memantine therapy compared to the control group, and there was no significant difference in the toxicity profile of the interventional compared to the control group as reported from two studies.</span></p></div><div><h3>Conclusion</h3><p>This review embraces the comprehensive evidence that the use of memantine therapy in patients<span><span> with brain metastases to prevent radiation-induced neurocognitive dysfunction has a modest and statistically significant beneficial impact in improving quality of life and preserving some neurocognitive function without any complications. Pending the completion of additional ongoing studies, one can argue that memantine is a reasonable treatment to consider in patients with brain metastases while they receive </span>whole brain radiation therapy.</span></p></div>\",\"PeriodicalId\":21750,\"journal\":{\"name\":\"Seminars in oncology\",\"volume\":\"50 3\",\"pages\":\"Pages 113-122\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Seminars in oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0093775423000659\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0093775423000659","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Efficacy of memantine in preventing neurocognitive dysfunction induced by radiation therapy in patients with brain metastases: A systematic review of clinical trials
Purpose
About 50%–90% of patients with brain metastases who receive radiation therapy experience cognitive impairment. This systematic review aims to gather credible sources of comprehensive information on the efficacy of memantine in preventing cognitive dysfunction.
Methods
A comprehensive review conducted in compliance with the PRISMA statement and systematic search was performed across five databases included PubMedⓇ, EmbaseⓇ, ScopusⓇ, Cochrane LibraryⓇ, and ClinicalTrial.gov.in from inception until November 2021.
Results
A total of four eligible studies were selected in this review that included 1,444 patients with brain metastases who received radiation therapy (Intervention group [n = 729] and control group [n = 715]). Overall, three of the four studies reported some improvement in neurocognitive function in at least one or more parameters such as recall and recognition (P = .39, P = .10 and P = .05), verbal fluency (P = .03 and P < .0001), complex attention (P = .59) executive function (P = .92) and normal appearing white matter (P = .01) following memantine therapy compared to control group. Further, two of the four studies reported an improvement in the patients’ quality of life following memantine therapy compared to the control group, and there was no significant difference in the toxicity profile of the interventional compared to the control group as reported from two studies.
Conclusion
This review embraces the comprehensive evidence that the use of memantine therapy in patients with brain metastases to prevent radiation-induced neurocognitive dysfunction has a modest and statistically significant beneficial impact in improving quality of life and preserving some neurocognitive function without any complications. Pending the completion of additional ongoing studies, one can argue that memantine is a reasonable treatment to consider in patients with brain metastases while they receive whole brain radiation therapy.
期刊介绍：
Seminars in Oncology brings you current, authoritative, and practical reviews of developments in the etiology, diagnosis and management of cancer. Each issue examines topics of clinical importance, with an emphasis on providing both the basic knowledge needed to better understand a topic as well as evidence-based opinions from leaders in the field. Seminars in Oncology also seeks to be a venue for sharing a diversity of opinions including those that might be considered "outside the box". We welcome a healthy and respectful exchange of opinions and urge you to approach us with your insights as well as suggestions of topics that you deem worthy of coverage. By helping the reader understand the basic biology and the therapy of cancer as they learn the nuances from experts, all in a journal that encourages the exchange of ideas we aim to help move the treatment of cancer forward.
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