Page 6 - Read Online

Wartena et al. J Cancer Metastasis Treat 2018;4:59 Journal of Cancer
DOI: 10.20517/2394-4722.2018.66 Metastasis and Treatment

Review Open Access

Are memantine, methylphenidate and donepezil
effective in sparing cognitive functioning after brain

irradiation?

Rosa Wartena , Dieta Brandsma , José Belderbos 3
2
1
1 Amsterdam Universitair Medische Centra, Amsterdam 1081HV, The Netherlands.
2 Department of Neuro-oncology, The Netherlands Cancer Institute, Amsterdam 1066CX, The Netherlands.
3 Department of Radiation Therapy, The Netherlands Cancer Institute, Amsterdam 1066CX, The Netherlands.
Correspondence to: Dr. José Belderbos, Department of Radiation Therapy, The Netherlands Cancer Institute, Amsterdam
1066CX, The Netherlands. E-mail: j.belderbos@nki.nl

How to cite this article: Wartena R, Brandsma D, Belderbos J. Are memantine, methylphenidate and donepezil effective in
sparing cognitive functioning after brain irradiation? J Cancer Metastasis Treat 2018;4:59.
http://dx.doi.org/10.20517/2394-4722.2018.66

Received: 22 Oct 2018 First Decision: 19 Nov 2018 Revised: 6 Dec 2018 Accepted: 7 Dec 2018 Published: 26 Dec 2018

Science Editor: Lucyna Kepka Copy Editor: Cui Yu Production Editor: Huan-Liang Wu

Abstract
One strategy to reduce neurocognitive deterioration in patients after brain irradiation is the use of neuroprotective
medication. To generate up-to date knowledge regarding neuroprotective agents we performed a systematic
review on the clinical effectiveness of three agents that were reported to have neuroprotective characteristics:
memantine, methylphenidate and donepezil. The use of memantine after brain irradiation showed a delay in
cognitive deterioration, although at 24 weeks this did not reach significance (P = 0.059). Lack of significance
is likely to be the result of the limited statistical power of 35% and memantine did show significant differences
in secondary outcomes. The study on methylphenidate was not conclusive. Donepezil revealed significant
differences in a few cognitive tests however no difference in global cognition was found. In addition, larger effects
were observed in individuals with greater cognitive dysfunction prior to treatment.

Keywords: Memantine, donepezil, methylphenidate, brain irradiation, neuroprotection, whole brain irradiation,
neuroprotective agent, lung cancer

INTRODUCTION
Radiotherapy is an important treatment modality for patients who suffer from primary brain tumours
or brain metastases. Adverse effects of brain irradiation include fatigue, nausea, cognitive decline, ataxia

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.jcmtjournal.com