Cognitive decline induced by cerebral radiotherapy: What to do?

Introduction Each year about 200 000 individuals undergo radiotherapy treatment to primary brain cancer or brain metastasis. The number of survivor has been rising with the improvement of treatment and techniques. The current evidence suggest a progressive cognitive decline in the years following brain irradiation, and show that 50% of the people that survive longer than 6months are most affected. Aim The authors propose to make a literature review, trying to expose the cognitive decline profile after cerebral brain therapy and how to choose the best therapeutic option. Methodology Literature review using the data base available in the Documentation Service of the Central Library of the Centro Hospitalar e Universitario de Coimbra. Results and conclusions The severity profile of cognitive decline influences the therapeutic options. The use of donepezile and memantine presents as good therapeutic option, showing improvement in several cognitive domains. Metilphenidate steel needs investigation but the evidence is that has positive impact in the improvement of fatigue and concentration. There are lack of studies using Gingko Biloba, but reveals high toxicity inducing gastrointestinal symptoms and risk of intracranial haemorrhage.