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A secondary endpoint in that trial, and the primary objective in this secondary analysis, was to identify baseline biomarkers associated with cognitive impairment after either form of radiotherapy for brain metastasis. Here we report our findings on APOE genotype and serum levels of associated proteins and their association with radiation-induced neurocognitive decline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective analysis of prospectively collected samples from a completed randomized clinical trial, patients provided blood samples every 3 months that were tested by genotyping and enzyme-linked immunosorbent assay, and results were analyzed in association with cognitive impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The APOE genotype was not associated with neurocognitive impairment at 3 months. However, low serum levels of ApoJ, ApoE, or ApoA protein (all P &amp;lt; .01) and higher amyloid beta (A\u03b2\u200a1\u201342) levels (P = .048) at baseline indicated a greater likelihood of neurocognitive decline at 3 months after SRS, whereas lower ApoJ levels were associated with decline after WBRT (P = .014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with these pretreatment serum markers should be counseled about radiation-related neurocognitive decline.<\/jats:p><\/jats:sec>","DOI":"10.1093\/neuonc\/noac262","type":"journal-article","created":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T23:40:39Z","timestamp":1670370039000},"page":"1123-1131","source":"Crossref","is-referenced-by-count":17,"title":["Association of circulating markers with cognitive decline after radiation therapy for brain metastasis"],"prefix":"10.1093","volume":"25","author":[{"given":"Kristin","family":"Huntoon","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The University of Texas MD Anderson Cancer Center , Houston, Texas , USA"},{"name":"The Brain Tumor Center, The University of Texas MD Anderson Cancer Center , Houston, Texas , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S Keith","family":"Anderson","sequence":"additional","affiliation":[{"name":"Alliance Statistics and Data Management Center, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla V","family":"Ballman","sequence":"additional","affiliation":[{"name":"Alliance Statistics and Data Management Center, Mayo Clinic , Rochester, Minnesota , USA"},{"name":"Department of Biostatistics and Epidemiology, Weill Medical College of Cornell University , New York, New York , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Twohy","sequence":"additional","affiliation":[{"name":"Alliance Statistics and Data Management Center, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharine","family":"Dooley","sequence":"additional","affiliation":[{"name":"Alliance Statistics and Data Management Center, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"An","sequence":"additional","affiliation":[{"name":"Department of Therapeutic Radiology, Yale-New Haven Hospital , North Haven, Connecticut , 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Jacksonville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane H","family":"Cerhan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony C","family":"Whitton","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, McMaster University , Hamilton, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey N","family":"Greenspoon","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, McMaster University , Hamilton, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian F","family":"Parney","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan B","family":"Ashman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mayo Clinic , Phoenix\/Scottsdale, Arizona , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Paul","family":"Bahary","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, CHUM , Montreal, Quebec , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantinos","family":"Hadjipanayis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Icahn School of Medicine at Mount Sinai , New York, New York , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J","family":"Urbanic","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California San Diego, Moores Cancer Center , La Jolla, California , 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