The effects of low-dose radiation therapy in patients with mild-to-moderate Alzheimer's dementia: an interim analysis of a pilot study
Radiation Oncology Journal 2023³â 41±Ç 2È£ p.89 ~ p.97
±è¾Æ·Ã(Kim A-Ryun) -
ÀÌÁ¤È¯(Lee Jeong-Hwan) -
¹®ÇѼÖ(Moon Han-Sol) -
±èöÇÑ(Kim Chul-Han) -
À¯¹Î¿µ(Yoo Min-Young) -
¹Ú¿ìÀ±(Park Woo-Yoon) -
±è¿øµ¿(Kim Won-Dong) -
¼¿µ¼®(Seo Young-Seok) -
Abstract
Purpose : We aimed to determine whether low-dose radiotherapy (LDRT) is effective in patients with Alzheimer disease (AD).
Materials and Methods : We included patients according to the following criteria: probable Alzheimer's dementia according to the New Diagnostic Criteria for Alzheimer¡¯s Disease; confirmation of amyloid plaque deposits on baseline amyloid positron emission tomography (PET); a Korean Mini-Mental State Examination 2nd edition (K-MMSE-2) score of 13?26; and a Global Clinical Dementia Rating (CDR) score of 0.5?2 points. LDRT was performed six times at 0.5 Gy each. Post-treatment cognitive function tests and PET-CT examinations were performed to evaluate efficacy. The medication for AD treatment was maintained throughout the study period.
Results : At 6 months after LDRT, neurological improvement was seen in 20% of patients. Patient #2 showed improvement in all domains of the Seoul Neuropsychological Screening Battery II (SNSB-II). Moreover, the K-MMSE-2 and Geriatric Depression Score-Short Form scores improved from 20 to 23 and from 8 to 2, respectively. For patient #3, the CDR score (sum of box score) improved from 1 (4.0) to 1 (3.5) at 3 months follow-up. Moreover, the Z scores for language and related functions, memory, and frontal executive function improved to -2.56, -1.86, and -1.32, respectively at the 6-month follow-up. Two patients complained of mild nausea and mild hair loss during LDRT, which improved after treatment.
Conclusion : One of the five patients with AD treated with LDRT experienced a temporary improvement in SNSB-II. LDRT is tolerable in patients with AD. We are currently under follow-up and will conduct cognitive function tests after 12 months after LDRT. A large-scale randomized controlled trial with a longer follow-up period is warranted to determine the effect of LDRT on patients with AD.
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Alzheimer's disease, Dementia, Low dose radiotherapy
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Caregivers of two of five patients reported improved cognitive function and improved memory. One patient complained of nausea (Grade II of CTCAE v5.0) during LDRT, which subsided after treatment. Another patient reported mild hair loss (Grade I of CTCAE v5.0) during LDRT, which also improved after the trial. No other adverse effects were observed.