Efficacy of memantine in preventing neurocognitive dysfunction induced by radiation therapy in patients with brain metastases: A systematic review of clinical trials

IF 3 3区医学 Q2 ONCOLOGY Seminars in oncology Pub Date : 2023-06-01 DOI:10.1053/j.seminoncol.2023.09.004

Haripriya Parapparambil Surendran , Sujit Kumar Sah , Dhanya Mary Louis , Sruthi Kalavagunta , Narmadha Mukunthu Poornachary , Selin Chiriyankandath Joy , Debnarayan Dutta

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Abstract

Purpose

About 50%–90% of patients with brain metastases who receive radiation therapy experience cognitive impairment. This systematic review aims to gather credible sources of comprehensive information on the efficacy of memantine in preventing cognitive dysfunction.

Methods

A comprehensive review conducted in compliance with the PRISMA statement and systematic search was performed across five databases included PubMed^Ⓡ, Embase^Ⓡ, Scopus^Ⓡ, Cochrane Library^Ⓡ, and ClinicalTrial.gov.in from inception until November 2021.

Results

A total of four eligible studies were selected in this review that included 1,444 patients with brain metastases who received radiation therapy (Intervention group [n = 729] and control group [n = 715]). Overall, three of the four studies reported some improvement in neurocognitive function in at least one or more parameters such as recall and recognition (P = .39, P = .10 and P = .05), verbal fluency (P = .03 and P < .0001), complex attention (P = .59) executive function (P = .92) and normal appearing white matter (P = .01) following memantine therapy compared to control group. Further, two of the four studies reported an improvement in the patients’ quality of life following memantine therapy compared to the control group, and there was no significant difference in the toxicity profile of the interventional compared to the control group as reported from two studies.

Conclusion

This review embraces the comprehensive evidence that the use of memantine therapy in patients with brain metastases to prevent radiation-induced neurocognitive dysfunction has a modest and statistically significant beneficial impact in improving quality of life and preserving some neurocognitive function without any complications. Pending the completion of additional ongoing studies, one can argue that memantine is a reasonable treatment to consider in patients with brain metastases while they receive whole brain radiation therapy.

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美金刚预防脑转移患者放射治疗引起的神经认知功能障碍的疗效：临床试验的系统综述。

目的：接受放射治疗的脑转移患者中，约有50%-90%出现认知障碍。这篇系统综述旨在收集关于美金刚在预防认知功能障碍方面的疗效的全面信息的可靠来源。方法：根据PRISMA声明进行全面审查，并在五个数据库中进行系统搜索，包括PubMedⓇ、Embase \9415，和ClinicalTrial.gov.in。结果：本综述共选择了四项符合条件的研究，其中包括1444名接受放射治疗的脑转移患者（干预组 = 729]和对照组[n = 715]）。总体而言，四项研究中有三项报告称，在至少一个或多个参数（如回忆和识别）方面，神经认知功能有所改善（P = .39，P = .10和P = .05）、语言流利性（P = .03和P<.0001）、复杂注意（P = .59）执行功能（P=.92）和正常白质（P = .01）。此外，四项研究中有两项报告称，与对照组相比，美金刚治疗后患者的生活质量有所改善，两项研究报告称，介入治疗的毒性特征与对照组没有显著差异。结论：这篇综述包含了全面的证据，即在脑转移患者中使用美金刚治疗来预防辐射诱导的神经认知功能障碍，在没有任何并发症的情况下，对提高生活质量和保留一些神经认知功能具有适度且统计学上显著的有益影响。在其他正在进行的研究完成之前，有人可以说，在接受全脑放射治疗的脑转移患者中，美金刚是一种合理的治疗方法。

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来源期刊

Seminars in oncology 医学-肿瘤学

CiteScore

6.60

自引率

0.00%

发文量

审稿时长

104 days

期刊介绍： Seminars in Oncology brings you current, authoritative, and practical reviews of developments in the etiology, diagnosis and management of cancer. Each issue examines topics of clinical importance, with an emphasis on providing both the basic knowledge needed to better understand a topic as well as evidence-based opinions from leaders in the field. Seminars in Oncology also seeks to be a venue for sharing a diversity of opinions including those that might be considered "outside the box". We welcome a healthy and respectful exchange of opinions and urge you to approach us with your insights as well as suggestions of topics that you deem worthy of coverage. By helping the reader understand the basic biology and the therapy of cancer as they learn the nuances from experts, all in a journal that encourages the exchange of ideas we aim to help move the treatment of cancer forward.