脑转移癌全脑放疗对患者前瞻性记忆的影响  

Prospective memory in patients with brain metastases after whole brain radiotherapy

作　　者：程怀东[1] 李文[1] 杨俊[1] 夏曦[1] 黄忠连[1] 

机构地区：[1]安徽医科大学第二附属医院肿瘤中心,安徽合肥230601

出　　处：《中华肿瘤防治杂志》2015年第24期1911-1913,共3页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家自然科学基金(81372487)

摘　　要：目的脑转移癌患者全脑放疗(whole brain radiotherapy,WBRT)后前瞻性记忆损害的情况尚不清楚。本研究试图了解WBRT对脑转移癌患者基于事件前瞻性记忆(event based prospective memory,EBPM)与基于时间前瞻性记忆(time based prospective memory,TBPM)的影响。方法建立EBPM及TBPM的认知神经心理学试验范式,以2011-03-15-2015-02-15安徽医科大学第二附属医院肿瘤科40例脑转移癌住院患者为研究对象。在WBRT前后分别进行简易精神状态量表(Mini-Mental State Examination,MMSE)及EBPM、TBPM的测查,比较WBRT前后脑转移癌患者的MMSE、EBPM及TBPM成绩的改变。结果脑转移癌患者全脑放疗后MMSE得分为(26.05±1.06)分,较放疗前的(27.20±1.29)分减少;全脑放疗后DS得分为(6.45±0.88)分,较放疗前的(7.70±0.69)分减少;全脑放疗后VFT得分为(8.38±1.75)分,较放疗前的(10.00±2.17)分减少,差异均有统计学意义,P值均<0.05。脑转移癌患者全脑放疗后EBPM得分为(1.55±1.11)分,较放疗前的(2.48±0.93)得分有明显降低,差异有统计学意义,z=-3.344,P<0.01;全脑放疗后TBPM得分为(4.90±1.03)分,较放疗前的(4.70±1.14)无明显变化,差异无统计学意义,t=-1.599,P>0.05。结论脑转移癌患者WBRT后总体认知功能水平降低;前瞻性记忆以EBPM损害较为突出,而TBPM无明显变化;提示WBRT对脑转移癌患者前瞻性记忆损害存在一定程度的不均值性。OBJECTIVE There is no evidence about prospective memory impairment in patients with brain metasta- ses after whole brain radiotherapy （WBRT）. This study aimed to investigate event and time-based prospective memory （EBPM, TBPM） in these patients after WBRT. METHODS We set a battery of neuropsychological tests including MMSE（Mini-Mental State Examination） and EBPM or TBPM tasks. Forty patients with brain metastases who came from the department of oncology in the Second Affiliated Hospital of Anhui Medical University were enrolled in this study from March 15, 2011 to February 15, 2015. Each patients were performed with these tests before and after whole brain radiotherapy. RESULTS Compared with patients before radiotherapy, patients after radiotherapy had significant lower performance on MMSE（26.05±1.06, 27.20±1.29, t = 6. 233, P〈0.05）, and there was significant lower performance on EBPM （1.55±1.11, 2.48±0.93, z=-3. 344, P〈0.01）, but not on TBPM（4.90± 1.03 ;4.70±1. 14,t=-1. 599, P〈0.05）. CONCLUSIONS Patients with brain metastases who undergo whole brain radiotherapy were impaired on general cognition, and especially impaired on EBPM, but it had little impact on TBPM. All these indicated that the effects of whole brain radiotherapy on prospective memory may exist heterogeneity.

关 键 词：全脑放疗 脑转移癌 认知 前瞻性记忆 

分 类 号：R739.4[医药卫生—肿瘤]