Phase II study of donepezil in irradiated brain tumor patients: effect on cognitive function, mood, and quality of life

J Clin Oncol. 2006 Mar 20;24(9):1415-20. doi: 10.1200/JCO.2005.03.3001.

Abstract

Purpose: A prospective, open-label phase II study was conducted to determine whether donepezil, a US Food and Drug Administration-approved reversible acetylcholinesterase inhibitor used to treat mild to moderate Alzheimer's type dementia, improved cognitive functioning, mood, and quality of life (QOL) in irradiated brain tumor patients.

Patients and methods: Thirty-four patients received donepezil 5 mg/d for 6 weeks, then 10 mg/d for 18 weeks, followed by a washout period of 6 weeks off drug. Outcomes were assessed at baseline, 12, 24 (end of treatment), and 30 weeks (end of wash-out). All tests were administered by a trained research nurse.

Results: Of 35 patients who initiated the study, 24 patients (mean age, 45 years) remained on study for 24 weeks and completed all outcome assessments. All 24 patients had a primary brain tumor, mostly low-grade glioma. Scores significantly improved between baseline (pretreatment) and week 24 on measures of attention/concentration, verbal memory, and figural memory and a trend for verbal fluency (all P < .05). Confused mood also improved from baseline to 24 weeks (P = .004), with a trend for fatigue and anger (all P < .05). Health-related QOL improved significantly from baseline to 24 weeks, particularly, for brain specific concerns with a trend for improvement in emotional and social functioning (all P < .05).

Conclusion: Cognitive functioning, mood, and health-related QOL were significantly improved following a 24-week course of the acetylcholinesterase inhibitor donepezil. Toxicities were minimal. We are planning a double blinded, placebo-controlled, phase III trial of donepezil to confirm these favorable results.

Publication types

  • Clinical Trial, Phase II
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Affect / drug effects*
  • Aged
  • Anger
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / radiotherapy
  • Cholinesterase Inhibitors / therapeutic use*
  • Cognition Disorders / drug therapy*
  • Cognition Disorders / etiology
  • Donepezil
  • Fatigue
  • Female
  • Glioma / drug therapy*
  • Glioma / radiotherapy
  • Humans
  • Indans / therapeutic use*
  • Male
  • Memory
  • Middle Aged
  • Piperidines / therapeutic use*
  • Prospective Studies
  • Quality of Life
  • Radiation Injuries / drug therapy*

Substances

  • Cholinesterase Inhibitors
  • Indans
  • Piperidines
  • Donepezil