CAJ | 학술논문

目的探讨脑转移癌( BM)患者全脑放疗( WBRT)后认知功能的改变。方法以41例接受WBRT的BM患者为研究对象,以简易精神状态量表( MMSE)作为认知评估工具,对其放疗前1周、放疗后1周、1~6个月进行总体认知评估,并观察有无神经系统症状的BM患者(各12例)放疗前后的总体认知功能的改变。结果41例患者放疗前与放疗后1周比较差异有统计学意义(28.146±0.528 vs 27.585±0.290,P=0.006)；放疗前无神经系统症状组,放疗后4个月MMSE减低最明显,其后有所提高,放疗后4个月与放疗前患者的 MMSE 成绩(29.125±0.579 vs 26.500±0.524)比较,差异有统计学意义( P<0.01)；而有神经系统症状组放疗后4个月MMSE成绩提高,与放疗前(25.000±0.524 vs S27.500±0.370)比较,差异有统计学意义(P=0.001)。结论 WBRT对认知功能有损害,放疗后约4个月认知功能损害最明显,其后有所恢复。且放疗前有无神经系统症状与其放疗后的认知功能改变存在单分离。
목적탐토뇌전이암( BM)환자전뇌방료( WBRT)후인지공능적개변。방법이41례접수WBRT적BM환자위연구대상,이간역정신상태량표( MMSE)작위인지평고공구,대기방료전1주、방료후1주、1~6개월진행총체인지평고,병관찰유무신경계통증상적BM환자(각12례)방료전후적총체인지공능적개변。결과41례환자방료전여방료후1주비교차이유통계학의의(28.146±0.528 vs 27.585±0.290,P=0.006)；방료전무신경계통증상조,방료후4개월MMSE감저최명현,기후유소제고,방료후4개월여방료전환자적 MMSE 성적(29.125±0.579 vs 26.500±0.524)비교,차이유통계학의의( P<0.01)；이유신경계통증상조방료후4개월MMSE성적제고,여방료전(25.000±0.524 vs S27.500±0.370)비교,차이유통계학의의(P=0.001)。결론 WBRT대인지공능유손해,방료후약4개월인지공능손해최명현,기후유소회복。차방료전유무신경계통증상여기방료후적인지공능개변존재단분리。
Objective To investigate the change of cognitive function associated with whole brain radiotherapy for brain metastases after treatment. Methods The study was based on patients (n=41) of brain metastases who re-ceived whole brain radiotherapy, and MMSE was used as a cognitive assessment tool. Cognitive assessments were taken for the patients the week before radiotherapy, one week after radiotherapy and monthly after that, until 6 months later, to observe overall cognitive changes. And in which the change of cognitive function of the patients be-fore and after treatment with and without neurological symptoms group (12cases per group) was observed. Results there was significafint difference between Baseline MMSE score and the score one week after radiotherapy in the 41 patients (28. 146±0.528 vs 27.585±0.290, P=0.006). In no-neurological symptoms group(n=12 ),cog-nitive decline was predominant in the fourth month, but improved subsequently, baseline MMSE score and the MMSE score 4 months after radiotherapy was significantly different ( 29.125 ±0.579 vs 26.500 ±0.524 , P <0.01 ) . In Neurological symptoms group with baseline MMSE score≤26 ( n=12 ) , cognitive increase was predomi-nant in the fourth month, baseline MMSE score and the MMSE score 4 months after radiotherapy was significantly different(25.000±0.524 vs 27.500±0.370,P=0.001). Conclusion Whole brain radiotherapy may contribute to the cognitive impairment. The damage is a slow pathological process which is predominant 4 months after radio-therapy,but recover slightly after that;there is a single dissociation between neurological symptoms group and no-neurological symptoms group.