Evaluation of Toxic Effects of Chemotherapy in Lung Malignancies on Cerebral White Matter Using Diffusion Tensor Imaging

Abstract

Objectives: Non-small cell lung cancer (NSCLC) is a leading cause of morbidity and mortality. Carboplatin and cisplatin based regimens are used in the treatment of NSCLC. The aim of our study was to find out whether there is a difference in white matter (WM) changes between two platinum-based chemotherapy agents using DTI.

Materials and Methods: 25 patients who received chemotherapy for NSCLC and 27 age-matched healthy controls were enrolled in the study. FA, AD, MD and RD values of the study population were measured from 11 regions of interest in pre-chemotherapy and post-chemotherapy MRI data.

Results: Cisplatin group showed a significant decrease in the FA of the inferior longitudinal fasciculus (P=.028). Carboplatin group showed a significant FA decrease and RD increase in the forceps minor (P=.022 and P=.011, respectively), and a significant reduction in AD and increase in MD in FWM (P=.008 and P=.029, respectively). In comparison of postchemotherapy DTI values of the two groups, carboplatin group showed lower FA, and higher MD and RD values than cisplatin group in parieto-occipital WM (P=.034, P=.034, P=.029, respectively).

Conclusion: Our findings suggest that subtle effects of chemotherapy detectable with DTI may emerge after the treatment. In addition, carboplatin regimen may have more toxic impact on WM than cisplatin regimen.