40 Chapter 2 Table 4: Main message of the studies categorized by type of radiotherapy. T = time point in months after radiotherapy. (continued) 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 Zhu et al., 2018 40 33 29-31* 26-29* 22-26* T0 T3 T6 T9 RCI T3: T6: T9: Deteriorated cognitive performance was found on learning and memory, executive function and verbal fluency in 19%, 29% and 28% of the patients, respectively. Deteriorated cognitive performance was found on learning and memory, executive function and verbal fluency in 48%, 48% and 50% of the patients, respectively. Deteriorated cognitive performance was found on learning and memory, executive function and verbal fluency in 50%, 58% and 57% of the patients, respectively. Westover et al., 2020 41 47 18 8 5 T0 T3 T6 T9 T12 ≤1 SD decline from the mean T3: T6: Compared to T0 learning & memory performance declined in 17% of the patients on delayed recall with a mean decline of 11%. No significant changes were found on the other cognitive tasks, but there were large variations. Mean learning & memory performance (delayed recall) recovered to pre-treatment values. Onodera et al., 2014 25 20 17 14 9 T0 T4 T8 T12 N.A. T4: Patients receiving WBRT deteriorated significantly compared to T0 on learning and memory (delayed recall). Additional analysis showed only patients with a brain edema volume ≥16.8 cc. decreased on learning and memory (delayed recall) and executive function. T8: Patients receiving WBRT deteriorated significantly compared to T0 and T4 on learning and memory (immediate recall). Improvements in immediate and delayed recall at T8 compared to T4 were only observed in patients with a <4.0 cc total volume of BM at T0.
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