Longitudinal study of irradiation-induced brain functional network alterations in patients with nasopharyngeal carcinoma.

Radiother Oncol

Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China. Electronic address:

Published: August 2022

AI Article Synopsis

  • The study examines changes in brain networks due to radiotherapy in patients with nasopharyngeal carcinoma over time, comparing their progress with that of healthy controls.
  • A total of 36 NPC patients were assessed at four different timepoints post-RT, using neuroimaging and cognitive tests to analyze brain changes and develop predictive models.
  • The results show significant alterations in nodal efficiency in NPC patients that follow a "decrease-increase/recovery" pattern, highlighting the potential for predicting brain dysfunction from treatment parameters.

Article Abstract

Background: To investigate radiotherapy (RT)-related brain network changes in patients with nasopharyngeal carcinoma (NPC) over time and develop least absolute shrinkage and selection operator (LASSO)-based multivariable normal tissue complication probability (NTCP) models to predict RT-related brain network changes.

Methods: 36 NPC patients were followed up at four timepoints: baseline, within 3 months (acute), 6 months (subacute), and 12 months (delayed) post-RT. 15 comparable healthy controls (HCs) were finally included and followed up in parallel. Functional neuroimaging data, dose-volume parameters of bilateral temporal lobes and Montreal Cognitive Assessment (MoCA) were acquired. Graph theoretical analysis and mixed-design analysis of variance were performed to investigate how the brain global and nodal changes were affected by RT. Multivariate logistic regression NTCP models were developed. LASSO with nested cross-validation strategy was used to select features. The relationships between network changes and MoCA changes were also examined.

Results: Significant changes were detected in nodal efficiency (NE) in NPC patients but not in HCs over time. Altered NE was distributed in the bilateral frontal, temporal lobes and the right insula, which showed a "decrease-increase/recovery" pattern over time. Among all models, the model for predicting NE changes of STG.R showed a relatively good performance (area under the receiver operating curve: 0.68), and D and V to right temporal lobe outperformed in this model.

Conclusion: Our findings indicate that RT-induced brain injury begin at the acute period and follow a recovery over time. Furthermore, our study presents prediction models for brain dysfunction based on the dosimetric and clinical parameters.

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http://dx.doi.org/10.1016/j.radonc.2022.06.008DOI Listing

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