Proceedings of the 52nd Annual ASTRO Meeting S293

low dose steroids post IGRT and only one patient experienced severe edema requiring hospitalization. No other significant treat-ment-related toxicities were observed.

Conclusions: IGRT is a viable strategy to treat intracranial meningiomas, alone or in combination with surgery. Tumor progressionwas similar to previous studies. Acute toxicity was minimal over the broad range of fraction schemes employed.

Author Disclosure: S.M. Nimjee, None; R.M. Reynolds, None; I.O. Karikari, None; K.J. Allen, None; J.H. Sampson, None; A.H.Friedman, None; G.W. Britz, None; A.R. Zomorodi, None; Z. Wang, None; J. Kirkpatrick, Varian Medical Systems, B. ResearchGrant; Genentech, B. Research Grant; Varian Medical Systems, D. Speakers Bureau/Honoraria; BrainLab, D. Speakers Bureau/Honoraria.

2199 Low-dose Whole Brain Radiotherapy followed by Radiosurgery for Primary CNS Lymphoma Achieving

Partial Response to Induction Chemotherapy

D. S. Oh, D. A. Reardon, L. R. Prosnitz, J. P. Gockerman, J. Sampson, J. P. Kirkpatrick

Duke University, Durham, NC

Purpose/Objective(s): For patients with primary CNS lymphoma who achieve complete response (CR) after induction chemo-therapy, low-dose whole brain radiation therapy (LD-WBRT; 20-30 Gy) appears effective and is well tolerated. For patientswho respond to induction chemotherapy but have residual disease less than 3 cm in size we hypothesized that LD-WBRT followedby radiosurgery would be effective at controlling residual disease and would be well tolerated.

Materials/Methods: Four patients with primary CNS lymphoma with response to induction chemotherapy but with residualdisease less than 3 cm were identified. Their ages ranged from 25 to 77 years old. Induction chemotherapy consisted ofhigh-dose methotrexate with or without additional agents. LD-WBRT comprised 2340 cGy in 13 fractions. This was immedi-ately followed by one radiosurgery treatment of 12-12.5 Gy to the focus of residual disease defined on contrast-enhanced T1weighted MRI.

Results: The median follow-up was 17.1 months (range, 10-23 months). All patients had residual disease after induction chemo-therapy but achieved CR following LD-WBRT and radiosurgery. Three patients remain free of disease. One patient developeddistant brain recurrence 12 months after radiation but remains alive at last follow-up (17 months). No treatment related neurotox-icity was observed.

Conclusions: The combination of induction chemotherapy, LD-WBRT and radiosurgery appears effective and well tolerated inpatients with primary CNS lymphoma who achieve a PR to chemotherapy with minimal residual disease. Longer follow-upand larger patient numbers are clearly needed for confirmation.

Author Disclosure: D.S. Oh, None; D.A. Reardon, None; L.R. Prosnitz, None; J.P. Gockerman, None; J. Sampson, None; J.P.Kirkpatrick, None.

2200 An Internationally Compatible, Japanese Neurocognitive Function Test Battery for the Assessment of

Radiation-induced Brain Injury

S. Onodera1, H. Aoyama2, N. Hashimoto1, A. Toyomaki1, N. Nishikawa1, K. K. Tha1, K. Ogisu1, S. Terae1, H. Shirato1

1Hokkaido University Graduate School of Medicine, Sapporo, Japan, 2Niigata University Graduate School of Medical andDental Sciences, Niigata, Japan

Purpose/Objective(s): The damage of neurocognitive function induced by cranial irradiation or progression of brain metastasiswas demonstrated by past reports including Japanese population. In these literatures, WAIS, AVLT, and other recognition testswere reported to be useful but they required long time for examination. On the other hand, simple tests, such as Mini-Mental StateExamination (MMSE), were easily performed but reported to be less sensitive to neurocognitive dysfunctions after radiotherapy.Thus, we developed a new Japanese neurocognitive function test battery (NCFT), which is compatible with international standardand obtainable within one hour. Its feasibility for patients with brain metastasis who would receive cranial irradiation was inves-tigated in this report.

Materials/Methods: Patients with KPS 70 or more, age between 20 and 80, who would receive whole brain irradiation (WBI) orstereotactic irradiation (STI) for metastatic brain tumors were candidates for this study. A new NCFT, which included a part ofRBANS (immediate memory test and delayed memory test), Trail-Making-Test (TMT, part A and B), and MMSE was created.The NCFT was undertaken before radiotherapy, 4 months and 8 months after radiotherapy. Statistical analyses were performedby Friedman and Wilcoxon signed-rank test.

Results: Twenty-four patients entered between March 2009 and February 2010. The number of patients who received WBI was 19and STI was 5. Twelve patients (WBI 9, STI 3) were followed over 4 months after radiotherapy and 6 (WBI 3, STI 3) patientsfollowed over 8 months at March 2010. In WBI group, tumor progression was observed at 4 months after RT in one patientand at 8 months in two patients. In STI group, one patient experienced local progression at 2 months. The mean time ± SD requiredfor NCFT was 39 (4), 40 (4), and 39 (4) minutes to each patient before RT, at 4 months, and at 8 months, respectively. In WBIgroup, the delayed memory (list recognition) score in RBANS significantly reduced at 4 months (p = 0.031); in TMT, the timeprolonged at part B and the difference between part B and part A became statistically significant at 4 months (p = 0.008,0.012). However, part B in TMT and RBANS were suggested to have recovered at 8 months compared to those at 4 months.In STI group, no significant change was observed through the observation period. In MMSE, no change was observed in bothWBI group and STI group.

Conclusions: The new Japanese neurocognitive function test battery was feasible to be examined at the bedside or out-patientclinic with about 40 minutes for each patient. This battery was applicable to evaluate the damage of the cognitive function for pa-tients with brain metastasis before radiotherapy, 4 months and 8 months after treatment.

Author Disclosure: S. Onodera, None; H. Aoyama, None; N. Hashimoto, None; A. Toyomaki, None; N. Nishikawa, None; K.K.Tha, None; K. Ogisu, None; S. Terae, None; H. Shirato, None.