Interventions for preventing and ameliorating cognitive deficits in adults treated with cranial irradiation

Background Cognitive deficits are common in people who have received cranial irradiation and have a serious impact on daily functioning and quality of life. The benefit of pharmacological and non‐pharmacological treatment of cognitive deficits in this population is unclear. This is an updated version of the original Cochrane Review published in Issue 12, 2014. Objectives To assess the effectiveness of interventions for preventing or ameliorating cognitive deficits in adults treated with cranial irradiation. Search methods For this review update we searched the Cochrane Register of Controlled Trials (CENTRAL), MEDLINE via Ovid, Embase via Ovid, and PsycInfo via Ovid to 12 September 2022. Selection criteria We included randomised controlled (RCTs) trials that evaluated pharmacological or non‐pharmacological interventions in cranial irradiated adults, with objective cognitive functioning as a primary or secondary outcome measure. Data collection and analysis Two review authors (MK, JD) independently extracted data from selected studies and carried out a risk of bias assessment. Cognitive function, fatigue and mood outcomes were reported. No data were pooled. Main results Eight studies met the inclusion criteria and were included in this updated review. Six were from the original version of the review, and two more were added when the search was updated. Nineteen further studies were assessed as part of this update but did not fulfil the inclusion criteria. Of the eight included studies, four studies investigated “prevention” of cognitive problems (during radiotherapy and follow‐up) and four studies investigated “amelioration” (interventions to treat cognitive impairment as a late complication of radiotherapy). There were five pharmacological studies (two studies on prevention and three in amelioration) and three non‐pharmacological studies (two on prevention and one in amelioration). Due to d