286 - Validating the FACT-Br Cognitive Index for Early Detection of Radiation-Induced Cognitive Decline in Primary Brain Tumors
Presenter(s)
A. M. Chirban1, A. Reyes2, J. S. Kohli3, N. Menendez2, C. McDonald3, and J. A. Hattangadi-Gluth2; 1UC San Diego, School of Medicine, La Jolla, CA, 2Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, 3Department of Psychiatry, University of California San Diego, La Jolla, CA
Purpose/Objective(s): This study evaluated the utility of the Functional Assessment of Cancer Therapy-Brain Cognitive Index (FACT-Br CI) as a self-report measure of subjective cognitive symptoms and its sensitivity in detecting early cognitive decline in patients undergoing radiation therapy (RT) for primary brain tumors. We hypothesized that FACT-Br CI scores would correlate significantly with standardized neurocognitive tests, serving as early indicators of radiation-induced cognitive impairment.
Materials/Methods: In this prospective longitudinal study, 41 glioma patients initiating RT were evaluated at baseline, three months, and six months post-treatment. Participants completed the FACT-Br questionnaire, and standardized well-validated neurocognitive assessments measuring executive function, language, processing speed, verbal memory, and visual-spatial memory. The CI score was calculated from patient responses about concentration, memory, mental clarity, and thinking ability. Demographic, clinical, and psychosocial factors were recorded. Pearson correlation analyses and linear mixed-effects modeling assessed relationships between subjective cognitive reports and objective cognitive outcomes over time.
Results: FACT-Br CI scores positively correlated with standardized neurocognitive assessments in multiple domains at baseline: executive function (ß=0.14, p<0.001), language (ß=0.09, p=0.02), processing speed (ß=0.09, p<0.001), and verbal memory (ß=0.10, p=0.01). No significant association emerged for visual-spatial memory. Higher educational attainment predicted better FACT-Br CI scores (ß=2.57, 95% CI [0.52-4.62], p=0.01). Male sex (ß=-12.43, 95% CI [-23.5-1.36], p=0.03) and clinical depression (ß=-18.21, 95% CI [-33.84-2.57], p=0.02) correlated with lower scores. No significant cognitive decline was observed longitudinally within six months.
Conclusion: The FACT-Br CI is a promising self-report tool for identifying early subjective cognitive symptoms in primary brain tumor patients undergoing RT. Its strong correlations with several neurocognitive domains suggest its utility in early clinical identification, prompting further neuropsychological evaluation. Administration during routine clinical visits could facilitate timely interventions. Additional research with extended follow-up is necessary to validate long-term predictive capabilities and enhance clinical utility.
Abstract 286 - Table 1: Associations between the FACT-Br cognitive index and neurocognitive test domains
| Outcome | Coefficient | Std. Err. | Z | P>|z| | 95% Conf. Interval Lower | 95% Conf. Interval Upper |
| Executive | 0.14 | 0.03 | 4.79 | 0.0 | 0.08 | 0.2 |
| Language | 0.09 | 0.04 | 2.28 | 0.02 | 0.01 | 0.16 |
| Processing Speed | 0.09 | 0.03 | 3.4 | 0.0 | 0.04 | 0.14 |
| Verbal Memory | 0.1 | 0.04 | 2.47 | 0.01 | 0.02 | 0.18 |
| Visual-Spatial Memory | 0.02 | 0.05 | 0.39 | 0.7 | -0.07 | 0.11 |