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Deterioration of neurocognitive function (NCF) is commonly seen during and after WBRT. Knowledge on long-term effects in melanoma patients is limited due to short survival rates. With the introduction of immune checkpoint inhibitors, patients may experience ongoing disease control, emphasizing the need for paying more attention to potential long-term adverse effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this single-center study, we identified in a\u00a0period of 11\u00a0years all long-term survivors of MBM who received WBRT at least 1\u00a0year prior to inclusion. NCF was assessed by Neuropsychological Assessment Battery (NAB) screening and detailed neurological exam; confounders were documented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight patients (median age 55\u00a0years) could be identified with a\u00a0median follow-up of 5.4\u00a0years after WBRT. Six patients reported no subjective neurological impairment. NAB screening revealed an average-range score in 5\/8\u00a0patients. In 3\/8\u00a0patients a\u00a0NAB score below average was obtained, correlating with subjective memory deficits in 2\u00a0patients. In these patients, limited performance shown in modalities like memory function, attention, and spatial abilities may be considerably attributed to metastasis localization itself. Six out of 8\u00a0patients were able to return to their previous work.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Five of 8 long-term survivors with MBM after WBRT experienced little to no restriction in everyday activities. In 3 out of 8\u00a0patients, cognitive decline was primarily explained by localization of the metastases in functionally relevant areas of the brain. The results of our small patient cohort do not support general avoidance of WBRT for treatment of brain metastases. However, long-term studies including pretreatment NCF tests are needed to fully analyze the long-term neurocognitive effects of WBRT<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00066-022-01950-1","type":"journal-article","created":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T18:04:15Z","timestamp":1652292255000},"page":"884-891","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Long-term neurocognitive function after whole-brain radiotherapy in patients with melanoma brain metastases in the era of immunotherapy"],"prefix":"10.1007","volume":"198","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4310-4822","authenticated-orcid":false,"given":"Martin","family":"Salzmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Hess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Lang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander H.","family":"Enk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berit","family":"Jordan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica C.","family":"Hassel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,11]]},"reference":[{"issue":"8","key":"1950_CR1","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1056\/NEJMoa1805453","volume":"379","author":"HA Tawbi","year":"2018","unstructured":"Tawbi\u00a0HA, Forsyth\u00a0PA, Algazi\u00a0A, Hamid\u00a0O, Hodi\u00a0FS, Moschos\u00a0SJ et\u00a0al (2018) Combined nivolumab and Ipilimumab in melanoma metastatic to the brain. 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Ann Oncol 31(11):1435\u20131448","journal-title":"Ann Oncol"}],"container-title":["Strahlentherapie und Onkologie"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00066-022-01950-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00066-022-01950-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00066-022-01950-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T11:22:36Z","timestamp":1700565756000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00066-022-01950-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,11]]},"references-count":38,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["1950"],"URL":"https:\/\/doi.org\/10.1007\/s00066-022-01950-1","relation":{},"ISSN":["0179-7158","1439-099X"],"issn-type":[{"value":"0179-7158","type":"print"},{"value":"1439-099X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,11]]},"assertion":[{"value":"22 December 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 April 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"M.\u00a0Salzmann: honoraria and\/or travel grants from Abbvie, Bristol-Myers Squibb (BMS), Merck, Merck Sharp & Dohme (MSD), Novartis, Pfizer, and Sanofi-Aventis. A.H.\u00a0Enk: advisory honoraria from Biotest AG, MSD Oncology, Galderma, Janssen Cilag, and AbbVie as well as speaker\u2019s honoraria from Roche Pharma. B.\u00a0Jordan: honoraria for talks from Alexion, Temmler, Biomarin, Novartis; advisory board member of Alexion. J.C.\u00a0Hassel: honoraria for talks from BMS, MSD, Roche, Novartis; advisory board member for MSD, Pierre Fabre; scientific grant support from BMS; travel grants from BMS, Pierre Fabre. K.\u00a0Hess and K.\u00a0Lang declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}