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KMID : 1038620230410020089
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Radiation Oncology Journal
2023 Volume.41 No. 2 p.89 ~ p.97
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The effects of low-dose radiation therapy in patients with mild-to-moderate Alzheimer's dementia: an interim analysis of a pilot study
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Kim A-Ryun
Lee Jeong-Hwan
Moon Han-Sol
Kim Chul-Han
Yoo Min-Young
Park Woo-Yoon
Kim Won-Dong
Seo Young-Seok
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Abstract
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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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KEYWORD
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Alzheimer's disease, Dementia, Low dose radiotherapy
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