{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T11:03:37Z","timestamp":1779793417065,"version":"3.53.1"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K08 CA237881"],"award-info":[{"award-number":["K08 CA237881"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Treatment of locally\u2010advanced head and neck cancer (HNC) involves multiple therapeutic exposures that may directly or indirectly impact cognition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To describe long\u2010term cognitive impairment in a cohort of HNC survivors and to identify the cognitive domains most commonly affected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Materials<\/jats:title>\n                    <jats:p>\n                      This study enrolled patients with locally advanced or recurrent HNC who received radiation therapy (RT) and survived at least 2\u00a0years without recurrence. Participants completed a cognitive battery and quality of life measures. Performance in a cognitive domain was considered impaired if\n                      <jats:italic>T<\/jats:italic>\n                      &lt; 35. Logistic regression was used to assess the relationship between treatment exposures and other variables with impairment in each cognitive domain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The final cohort consisted of 185 participants. The proportion of patients classified with cognitive impairment by domain was 36.8% for fine motor, 32.7% for verbal memory, 27.0% for executive function, 7.6% for vocabulary, and 7.0% for working memory. In the final model for impaired verbal memory, only radiation dose to the medial temporal lobe (OR\u00a0=\u00a01.06,\u00a095% CI: 1.00\u20131.12) was significant. Time from RT (OR\u00a0=\u00a01.12, 95% CI: 1.01\u20131.24) and fatigue (OR\u00a0=\u00a03.45, 95% CI: 1.02\u201311.59) were associated with impaired working memory. Non\u2010white race (OR\u00a0=\u00a08.44, 95% CI: 3.23\u201322.05) and fatigue (OR\u00a0=\u00a02.68, 95% CI: 1.24\u20135.81) were associated with impaired executive function. Impaired emotional function and fatigue, but not cognitive battery performance, were associated with perceived cognitive impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study supports the hypothesis that many long\u2010term HNC survivors experience cognitive impairment. Higher radiation dose to the medial temporal lobe was associated with lower verbal memory performance, and fatigue was associated with impaired executive function, perceived cognitive abilities, and overall role functioning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70441","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T17:59:20Z","timestamp":1776448760000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characterizing Cognitive Outcomes Among Long\u2010Term Survivors of Locally Advanced Head and Neck Cancer"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1582-956X","authenticated-orcid":false,"given":"Andrew M.","family":"McDonald","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"University of Alabama at Birmingham Institute for Cancer Outcomes and Survivorship  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8636-7004","authenticated-orcid":false,"given":"Courtney A.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"University of Alabama at Birmingham Institute for Cancer Outcomes and Survivorship  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5768-123X","authenticated-orcid":false,"given":"Katherine A.","family":"Heinzman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"University of Alabama at Birmingham Institute for Cancer Outcomes and Survivorship  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2247-8596","authenticated-orcid":false,"given":"Robert A.","family":"Oster","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of General Internal Medicine and Population Science University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1414-3849","authenticated-orcid":false,"given":"Carlos E.","family":"Cardenas","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rex A.","family":"Cardan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noha","family":"Sharafeldin","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Institute for Cancer Outcomes and Survivorship  Birmingham Alabama USA"},{"name":"Division of Hematology and Oncology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7755-5683","authenticated-orcid":false,"given":"Smita","family":"Bhatia","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Institute for Cancer Outcomes and Survivorship  Birmingham Alabama USA"},{"name":"Department of Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8550-8353","authenticated-orcid":false,"given":"Donna L.","family":"Murdaugh","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Institute for Cancer Outcomes and Survivorship  Birmingham Alabama USA"},{"name":"Department of Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21731"},{"key":"e_1_2_14_3_1","volume-title":"Cancer Treatment & Survivorship Facts & Figures 2022\u20102024","author":"Society A. 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