38 Chapter 2 Table 4: Main message of the studies categorized by type of radiotherapy. T = time point in months after radiotherapy. RT type Authors and year of publication Number of patients Time points NCF assessed in months after RT Definition of cognitive change Main message WBRT Mehta et al., 2003 18,36–38 208 135 63-75* 43-46* 9 T0 T1 T2 T3 T4 T5 T6 T9 T12 T15 T18 ≤2 SD change in average Z-score T3: T4: T15: Most patients deteriorate on fine motor coordination and least patients on verbal fluency. Significant deterioration compared to T0 on learning and memory and verbal fluency. Significant improvement compared to T0 on verbal fluency, fine motor coordination and information processing speed. Gondi et al., 2014 26,27,33 100 53 42 29 T0 T2 T4 T6 RCI T2: T4: T6: 7-18% mean decline from T0 in learning and memory performance. In a subset of 33 patients with T0 MRI the change in learning & memory performance was correlated with BMs volume (immediate and delayed recall), age (immediate recall) and volume of white matter injuries pre-treatment (recognition). Certain aspects of learning and memory declined (delayed recall), while others remained stable (immediate recall and recognition). The mean relative decline from T0 to T6 was 0-3%. Saito et al., 2016 28 34 34 19 T0 T4 T8 RCI T4: T8: Learning and memory deteriorated significantly compared to T0 in those who only completed T0 and T4 assessments. In total 27-33% of the patients had deteriorated. On average stable cognitive performance was observed on learning and memory in subgroup completing assessments at all 3 time points. Of this subgroup, 11-26% had deteriorated learning and memory performance compared to baseline.
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