Cerebral Morbidity After Radiation Therapy for Brain Tumors
Cerebral Morbidity After Radiation Therapy for Brain Tumors
This study will assess cognitive function in patients with a primary brain tumour treated
 with radiation therapy (RT) to generate radio-sensitivity and volume effect parameters for
 the development of cognitive dysfunction. All types of brain tumours apart from glioblastoma
 will be included.
RT to brain tumours causes cognitive dysfunction. The extent of RT induced changes in
 cognitive function and radio-sensitivity of the brain is unknown. RT with protons instead of
 photons spares the healthy brain tissue more and is believed to reduce the risk of cognitive
 dysfunction. There is modest knowledge on which parts of the brain we need to spare, to
 prevent cognitive dysfunction.

 The study is a prospective nationwide study including approximately 60 brain tumour patients
 from the four neuro oncology centres in Denmark. The patients will do patient reported
 outcome (PRO) and undergo neuropsychological assessment with standardized tests: They will do
 this prior to RT treatment and ½, 1, 3 and 5 years afterwards. The PRO's included measures on
 quality of life, fatigue, sleep, depression, anxiety, and socio demografica. The standardized
 tests are: Trail making Test (TMT); Hopkins Verbal Learning Test (HVLT); Controlled Oral Word
 Association Test (COWAT) - Animals and S; Coding and Digit Span from WAIS-IV; Paced Auditory
 Serial Addition Test (PASAT). The correlation between cognitive scores and RT dose-volume
 parameters to specific areas in the brain will be tested.

 This study will elucidate the dose-response relationship in radiation-induced damage to
 substructures of the brain such as hippocampus, thalamus, temporal and frontal lobes that
 will allow the clinician to prioritize these structures in planning of proton radiotherapy.
Inclusion Criteria:

 -  18 years or older and Danish speaking.

 -  Performance status WHO 0-2

 -  Capable of cooperating on testing

 -  Tumor histology (WHO 2016 classification) of the following types: anaplastic
 astrocytoma (IDH mutant), diffuse astrocytoma (IDH-mutant), gemistocytic astrocytoma
 (IDH mutant), diffuse astrocytoma (NOS), oligidendroglioma, meningioma,
 medulloblastoma (NOS), pituitary adenoma, other brain tumours including skull base
 sarcomas

 Exclusion Criteria:

 -  Glioblastoma

 -  Performance status 3-4