Therapeutic role of memantine for the prevention of cognitive decline in cancer patients with brain metastasis receiving whole-brain radiotherapy: a narrative review

ABSTRACT. Brain metastases are the most common central nervous system tumors. The mainstay treatment for this tumor in low to middle income countries is whole brain radiation therapy. Irreversible cognitive decline is associated with the use of whole brain radiotherapy. Several pharmacologic and nonpharmacologic options have been employed in studies focusing on the prevention of cognitive decline following whole-brain radiation therapy. Memantine use has been shown to provide some benefit in reducing the rate of decline in cognitive function and time to cognitive failure. The objective of this review article is to provide a summary on available primary literature on the therapeutic role of memantine for the prevention of cognitive decline in cancer patients with brain metastasis receiving whole brain radiotherapy.

摘要。脑转移瘤是最为常见的中枢神经系统肿瘤。在中低收入国家，全脑放射治疗（whole brain radiation therapy）是该类肿瘤的主流治疗方案。然而，全脑放射治疗的使用与不可逆的认知功能衰退密切相关。目前已有多项研究探索了预防全脑放射治疗后认知衰退的药物及非药物干预手段。研究证实，美金刚（memantine）可在一定程度上减缓认知功能衰退的速率，并延迟认知功能衰竭的发生时间。本综述旨在梳理现有原始文献，总结美金刚在接受全脑放射治疗的脑转移瘤患者中，用于预防认知衰退的治疗价值。