Neurocognitive Challenges in Brain Tumor Survivors: Is There Anything We Can Do?
Mené sur 198 patients ayant subi, au moins six mois auparavant, une radiothérapie partielle ou totale du cerveau pour traiter une tumeur ou prévenir d'éventuelles métastases, cet essai de phase III évalue l'efficacité du donépézil, un inhibiteur spécifique et réversible de l'acétylcholinestérase, pour améliorer les capacités cognitives des patients
Neurocognitive and neuropsychological deficits after treatment of primary and metastatic tumors in the brain are significant, much feared survivorship challenges for a group of patients that is enlarging as treatment effectiveness for primary brain tumors and metastatic cancers improve. When reporting the initial phase II results1 that motivated the phase III trial that accompanies this editorial,2 Shaw et al framed this issue with a quotation from a survivor, Susan Sontag, 16 years after combined-modality therapy: “‘Everything I do is slow. I walk, talk, and think slowly… I still have no short-term memory… Much of the time I can't even remember the names of relatives and close friends… I am always confused… Because I look normal and often sound normal, people assume I am normal. But I'm not… I get depressed a lot knowing that I will never have my competence back.’ (Sontag Foundation Distinguished Scientists Awards ceremony speech at the Society for Neuro-Oncology Meeting, Toronto, Canada, November 20, 2004.)”2(p1415) Have there been advances in the last decade to address this problem, and does the phase III trial now reported provide evidence that contributes to an appropriate strategy?