Effects of chemotherapy and cranial radiation in brain structures and cognitive functions of lung cancer patients
Neurocognitive toxicity is an important dose-limiting factor as well as one of the main causes of morbidity in cancer patients. The impact of oncological treatments, including chemotherapy and cranial radiation, on cognition and their underlying neural changes, has become an increasing matter of interest in the last few years. Previous studies revealed that i) cancer patients treated with chemotherapy present mild cognitive deficits together with structural and functional brain changes, most commonly in the months following treatment that seem to persist only in a subgroup of long-term survivors; ii) those patients treated with cranial radiation present more severe cognitive deficits accompanied by structural white matter (WM) changes that seem to persist in an important group of the long-term survivors; and finally iii) some cancer patients present with cognitive complaints and white matter structural brain changes prior to receive any oncological therapy. However, nearly all these studies have focused on breast cancer population or patients with brain metastasis to study chemotherapy-related or cranial radiation-induced cognitive effects, respectively. To date, the potential neurotoxic effect of chemotherapy or prophylactic cranial irradiation (PCI) on cognition in lung cancer population has been scarcely studied.