Radiation-induced cognitive toxicity in adults

Cognitive toxicity induced by cranial radiation is one of the most important limitations of radiation therapy and has a significant impact on brain tumor survivors' quality of life. This review comprehends an up to date of recent studies including complete neuropsychological battery and/or advanced neuroimaging techniques. These studies identified critical anatomical and/or functional brain areas related to radiation-induced brain injury, thus improving clinical and radiological diagnosis. Pathophysiological mechanisms underlying cognitive toxicity are complex and involve different cell lines and molecules. Although there is no currently therapeutic strategy that has a demonstrated efficacy, several studies including sparing of hippocampus or the use of memantine are quite promising. A better knowledge of the characteristics of cognitive toxicity induced by cranial radiation, will help us to identify patients who will benefit from treatment and also to examine new therapeutic targets in order to improve patients' quality of life.