41 Cognitive Impact of SRS vs. WBRT: Systematic Review & Meta-analysis 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 Onodera et al., 2014 25 20 17 14 9 T0 T4 T8 T12 N.A. T12: In the subgroup of patients followed for at least 12 months, learning and memory (delayed recognition) had significantly declined compared to T0 at both T4 and T12. This subgroup also had significantly declined executive function at T4 compared to T0, with a similar trend at T12. Additionally, learning and memory (immediate recall) had returned to baseline values at T12 after a significant improvement at T8. No changes in verbal fluency, information processing speed or on cognitive screening measure at any time point. SRS 7 5 5 4 T0 T4 T8 T12 N.A. T4-12 SRS group had no change in cognitive performance for any tested cognitive construct over the entire study period. Chang et al., 2007 29 15 13 5 T0 T1 T2 T3 T4 T5 T7-9 T10-12 RCI T1: T7-9: All patients declined on ≥ 1 neuropsychological test and 54% on ≥ 2 tests, with decline in learning and memory (54%) and fine motor coordination (46%) most common. Improvements were also observed, mostly on executive function (38%), verbal fluency (15%), fine motor coordination (15%) and information processing speed (15%). Stable or improved cognitive performance was found for 80% of the patients for learning and memory, 60.0% for executive function and fine motor coordination. 2
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