43 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 SRS T12: In those patients surviving at least 12 months 60% deteriorated on at least 1 test compared to T=0. Most deteriorated on learning and memory (delayed recall) performance (20%) and none on verbal fluency. Habets et al., 2016 30,45 97 39 29 T0 T3 T6 ≤1.5 SD mean of healthy controls T6: The majority of the patients maintained their pre-treatment levels of cognitive performance over the entire study period. Only verbal fluency performance showed trend towards improvement. Minniti et al., 2020 44 38 32 26 21 T0 T3 T6 T12 RCI T3: T6: T12: Compared to T0 learning & memory performance declined in 13%, 16% and 19% of the patients on immediate recall, recognition and delayed recall. The mean decline varied between 10-14%. Compared to T0 learning & memory performance declined in 12%, 15% and 15% of the patients on immediate recall, recognition and delayed recall. The mean decline varied between 5-9%. Compared to T0 learning & memory performance declined in 5%, 10% and 14% of the patients on immediate recall, recognition and delayed recall. The mean decline varied between 2-5%. Abbreviations: N.A., not available; NCF, neurocognitive functioning; RCI, reliable change index; RT, radiotherapy; SD, standard deviations; SRS, stereotactic radiosurgery; WBRT, whole-brain radiotherapy; *ranges in patient numbers are caused by different numbers of patients completing the different cognitive tests during the study-procedures. 2
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