G-2451

Assessment of the Impact of Radiotherapy on the Incidence and Severity of Alz-heimer’s-Related Neurocognitive Impairment and the Role of Demographic Factors in Patients with Astrocytoma Brain Tumors: A Cross-Sectional Study

 Korosh Saber ¹ ℗, Miad Mirzapour ², Danesh Saeidyani ², Seyed Ali Rasooli ², Hossein Hassaninejad ³, Mohammad Sadegh Aboutalebi ⁴ ©   

 
Abstract

Introduction: Cancer remains one of the leading causes of global mortality, with the World Health Organization (WHO) reporting it as the second most common cause of death among individuals under 70 years of age in 2020. Among malignancies, brain tumors such as astrocytoma pose unique therapeutic challenges due to their anatomical location and impact on vital cerebral structures. Radiotherapy, a primary treatment modality for these tumors, effectively controls tumor growth but may lead to cognitive complications including memory and attention deficits when sensitive regions like the hippocampus are irradiated. This study aimed to investigate the association between radiotherapy and the onset of Alzheimer’s-related neurocognitive disorders in patients with astrocytoma, while analyzing the role of demographic factors in this process. Methods and Materials: This cross-sectional study was conducted in 2024 on 31 astrocytoma patients at Seyed Al-Shohada Hospital, Isfahan. Inclusion criteria comprised no prior history of neurological disorders (e.g., Alzheimer’s, multiple sclerosis, or traumatic brain injury) and receipt of standard radiotherapy (60 Gy in 30 sessions). Cognitive function was assessed using the Mini-Mental State Examination (MMSE) at two time points: pre-treatment and 90 days post-treatment. Demographic data, including age, sex, marital status, education level, economic status, and occupation, were collected. Statistical analysis was performed using SPSS v.26, with independent t-tests and one-way ANOVA applied to evaluate significance. Results: The mean age of participants was 50.09 ± 10.84 years, with 54.8% male and 87.1% married. MMSE scores decreased significantly from 27.03 ± 5.12 pre-radiotherapy to 24.77 ± 6.87 post-radiotherapy (P0.05). The number of patients diagnosed with Alzheimer’s increased from 6 (19.4%) to 11 (35.5%) post-treatment. Demographic analysis revealed significantly lower cognitive scores in males (24.35 ± 7.84 vs. 25.28 ± 5.73), married individuals (24.14 ± 7.15 vs. 29.00 ± 1.11), and those with elementary education (16.66 ± 5.04) (P0.05). Poor economic status (13.75 ± 3.86) and retirement occupations (14.00 ± 6.28) were associated with more severe cognitive decline. Conclusion and Discussion: The findings suggest radiotherapy not only exacerbates pre-existing cognitive impairments but may also act as a potential trigger for early-onset Alzheimer’s in susceptible patients. The significant decline in MMSE scores and a near-doubling of Alzheimer’s cases post-treatment underscore the necessity for regular cognitive monitoring in this population. The pronounced influence of socioeconomic variables, such as education and income, highlights the need for multidimensional supportive interventions. While limitations such as unaccounted environmental stressors exist, advanced radiotherapy techniques like proton therapy could mitigate hippocampal damage. Future studies should employ longitudinal designs and neurobiological markers to elucidate the precise mechanisms underlying this association.

Keywords: Radiotherapy, Cancer, Neurological Disorders, Alzheimer's