Analysis of neurocognitive functions in patients with brain metastasis of lung cancer

ZHEN JUN-jie; PENG Zhang-rui; LI Shao-qun; LAI Ming-yao; LING Xue-bing; WANG Li-chao; CAI Lin-bo

doi:10.13820/j.cnki.gdyx.20185298

Abstract：Objective To assess the baseline neurocognitive functions in patients with brain metastasis of lung cancer before radiotherapy, thus to determine the risk factors for neurocognitive function impairment. Methods The clinical data of patients suffering from brain metastasis from lung cancer were retrospectively analyzed. One-two weeks before radiotherapy for brain metastasis, several scales were used to assess the neurocognitive functions in the 74 patients.According to neurocognitive functions, the patients were assigned into 4 levels, normal, mild impairment, moderate impairment and severe impairment. All analyses were performed using the statistical package R. The correlations between cognitive assessment results and clinical characteristics were analyzed. And Kappa test was used to analyze the consistency of physical examination and cognitive scales. The related factors were analyzed with univariate and multivariate analysis.Results There were 21 cases of cognitive decline(28.4％)and 53 cases of normal cognition(71.6％), while the results of cognitive scales revealed that there were 6 cases of normal cognition(8.1％), 26 cases of mild impairment(35.1％), 2 cases of moderate impairment(2.7％)and 40 cases of severe impairment(54.1％). The result of Kappa test showed Kappa ＜ 0.4, indicating that the differences between cognitive scale results and physical examination were significant. The univariate analysis on the factors related to neurocognitive function impairment revealed that the risk factors that may affect the degree of neurocognitive function impairment included age, KPS score, GPA score, RPA class and the number of metastatic tumors. Multivariate analysis showed that age≥60 years old and RPA class＞ Ⅱ were the independent risk factors for neurocognitive function impairment. Conclusion Patients with brain metastasis of lung cancer have various degrees of neurocognitive function impairment before radiotherapy. Age≥60 years old and RPA class＞ Ⅱ are considered as independent risk factors for neurocognitive function impairment.