PAPEL TERAPÊUTICO DA MEMANTINA NA PREVENÇÃO DO DECLÍNIO COGNITIVO EM PACIENTES COM CÂNCER COM METÁSTASE CEREBRAL RECEBENDO RADIOTERAPIA CEREBRAL TOTAL: UMA REVISÃO NARRATIVA

Folloso, Melmar Cerilo; Torres, Mazelle; Ciocon, Stephen Lowell; Ong, Jed Noel; Flores, Jerickson Abbie; Catindig, Joseree-Ann

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Dementia & Neuropsychologia

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Sumário

Articles • Dement. neuropsychol. 16 (3) • jul-sep 2022 • https://doi.org/10.1590/1980-5764-DN-2021-0102 copiar

PAPEL TERAPÊUTICO DA MEMANTINA NA PREVENÇÃO DO DECLÍNIO COGNITIVO EM PACIENTES COM CÂNCER COM METÁSTASE CEREBRAL RECEBENDO RADIOTERAPIA CEREBRAL TOTAL: UMA REVISÃO NARRATIVA

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO.

As metástases cerebrais são os tumores mais comuns do sistema nervoso central. O tratamento principal para este tumor em países de baixa e média renda é a radioterapia de cérebro inteiro. O declínio cognitivo irreversível está associado ao uso de radioterapia cerebral total. Várias opções farmacológicas e não farmacológicas têm sido empregadas em estudos com foco na prevenção do declínio cognitivo após radioterapia de cérebro inteiro. O uso de memantina demonstrou fornecer algum benefício na redução da taxa de declínio na função cognitiva e no tempo até a falha cognitiva. O objetivo deste artigo de revisão foi fornecer um resumo da literatura primária disponível sobre o papel terapêutico da memantina para a prevenção do declínio cognitivo em pacientes com câncer com metástase cerebral recebendo radioterapia cerebral total.

Palavras-chave:
Memantina; Radioterapia; Neoplasias encefálicas; Cognição

Author (year)	Study design	Level of evidence	n¹	Inclusion criteria	Study arms	Outcome	Result of outcome
Brown et al. (2013)²⁶26. Brown PD, Pugh S, Laack NN, Wefel JS, Khuntia D, Meyers C, et al. Memantine for the prevention of cognitive dysfunction in patients receiving whole-brain radiotherapy: a randomized, double-blind, placebo-controlled trial. Neuro Oncol. 2013;15(10):1429-37. https://doi.org/10.1093/neuonc/not114 https://doi.org/https://doi.org/10.1093/...	Randomized double-blind, placebo-controlled trial	1	554	Adult patients with brain metastases receiving WBRT²	WBRT+memantine WBRT+placebo	HVLT-R for Delayed Recall at 24 weeks	No significant difference in delayed recall (primary outcome) between the two arms p=0.059)
Brown et al. (2020)²⁸28. Brown PD, Gondi V, Pugh S, Tome WA, Wefel JS, Armstrong TS, et al. Hippocampal avoidance during whole-brain radiotherapy plus memantine for patients with brain metastases: phase III trial NRG oncology CC001. J Clin Oncol. 2020;38(10):1019-29. https://doi.org/10.1200/JCO.19 https://doi.org/https://doi.org/10.1200/...	Randomized parallel, open-label controlled trial	1	518	Adult patients with brain metastases outside a 5-mm margin around either hippocampus receiving WBRT	WBRT+memantine HA-WBRT⁴+memantine	Time to cognitive function failure	Significant reduction in cognitive failure in patients under HA-WBRT plus memantine (adjusted hazard ratio, 0.74; 95%CI 0.58-0.95; p=0.02).
Wong et al. (2016)²⁷27. Wong P, Leppert IR, Roberge D, Boudam K, Brown PD, Muanza T, et al. A pilot study using dynamic contrast enhanced-MRI as a response biomarker of the radioprotective effect of memantine in patients receiving whole brain radiotherapy. Oncotarget. 2016;7(32):50986-96. https://doi.org/10.18632/oncotarget.9653 https://doi.org/https://doi.org/10.18632...	Randomized parallel, open-label placebo-controlled trial	1	14	Adult patients with brain metastases receiving WBRT (12 from RTOG 0614)	WBRT+placebo WBRT+Memantine*	DCE-MRI measures of tumor tissue and normal-appearing white matter (NAWM) vascular permeability	significantly (p=0.01) reduced normal-appearing vascular permeability changes following radiotherapy
Laack et al. (2018)²⁵25. Laack NN, Pugh SL, Brown PD, Fox S, Wefel JS, Meyers C, et al. The association of health-related quality of life and cognitive function in patients receiving memantine for the prevention of cognitive dysfunction during whole-brain radiotherapy. Neurooncol Pract. 2019;6(4):274-82. https://doi.org/10.1093/nop/npy038 https://doi.org/https://doi.org/10.1093/...	Randomized parallel, open-label controlled trial	1	442	Adult patients with brain metastases receiving WBRT (from RTOG 0614)	WBRT+memantine WBRT+placebo	Association of health-related quality of life and cognitive function	Baseline cognitive function correlated significantly with Medical Outcomes Scale-Cognitive Functioning Scale (MOS-C).

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Correspondence: Melmar Cerilo Folloso; Email: melmar.folloso@gmail.com.