A prospective evaluation of cognitive function in patients with early breast cancer receiving adjuvant chemotherapy

Ruzich, Michelle J; Ryan, Bonita F.; Owen, Cathy; Delahunty, A.; Stuart-Harris, R.

doi:10.1200/jco.2004.22.90140.549

Cited by 5 publications

(8 citation statements)

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“…Eight reported worsening SCI from baseline to during or immediately after chemotherapy completion (within 1 month) . When examining changes from baseline to 1 month or longer following chemotherapy completion, four studies reported recovery to baseline levels and one study reported no longitudinal changes, suggesting an acute impact of chemotherapy on SCI. In contrast, five studies reported no significant change from baseline to active treatment or within 1 month after treatment, mostly in non–breast‐cancer samples .…”

Section: Resultsmentioning

confidence: 99%

“…When examining changes from baseline to 1 month or longer following chemotherapy completion, four studies reported recovery to baseline levels and one study reported no longitudinal changes, suggesting an acute impact of chemotherapy on SCI. In contrast, five studies reported no significant change from baseline to active treatment or within 1 month after treatment, mostly in non–breast‐cancer samples . Seven studies reported the prevalence of significant cognitive decline after initiating chemotherapy (from 11% to 37%) .…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of longitudinal studies on chemotherapy‐associated subjective cognitive impairment in cancer patients

et al. 2020

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Objectives: This systematic review of longitudinal studies, assessing subjective cognitive impairment (SCI) reported by adult cancer patients, aimed to summarize evidence on the impact of chemotherapy on SCI, identify moderators of SCI, and evaluate methodological issues. Methods: Data accrued from Pubmed, EMBASE, CINAHL, PsychInfo, and the Cochrane library. Inclusion criteria were original studies, an exclusively adult sample, valid and reliable subjective cognitive measures, and at least one baseline data point prior to and another after the initiation of chemotherapy. Data were collected on the sample composition, data-collection time points, outcome measures, statistical analysis, and major findings (ie, longitudinal changes in prevalence, severity, and associated factors).Results: Forty articles published between 2004 and 2019 were retained: 21 examined chemotherapy-treated patients only, and 19 employed control groups. Findings were mixed, with slightly more studies supporting the impact of chemotherapy on SCI. SCI tended to be more prevalent and severe after initiating chemotherapy, compared with patients' own baseline and controls not treated with chemotherapy. Impact appeared to be acute and more likely limited to subsamples. Most studies examining non-breast-cancer samples reported the lack or limited impact of chemotherapy on SCI. The most consistent moderators were depression and fatigue. Methodological issues regarding sampling design, measurement, and statistical analysis were discussed.Conclusion: More rigorously designed longitudinal studies would clarify direct and indirect effects of chemotherapy on SCI. K E Y W O R D S anxiety, cancer, cognitive function, cognitive impairment, depression, fatigue, oncology, systematic review

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Systematic review of longitudinal studies on chemotherapy‐associated subjective cognitive impairment in cancer patients

et al. 2020

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“…Certain cross-sectional and prospective studies have failed to prove its existence (Ruzich et al, 2007; Du et al, 2010) while other prospective trials using in-depth neuropsychiatric testing have shown that cancer therapy does cause impairment in specific cognitive domains (Falleti et al, 2005; Stewart et al, 2006, 2008; Quesnel et al, 2008; Jansen et al, 2011). To explain these results, we turned to the literature and below we present a brief summary of the research surrounding this issue.…”

Section: Discussionmentioning

confidence: 99%

The impact of cancer therapy on cognition in the elderly

et al. 2013

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Cancer and cancer therapy-related cognitive impairment (formerly known as chemobrain or chemo-fog) are often described in the literature. In the past, studies have failed to prove the existence of cancer therapy-related cognitive dysfunction. However, more recently, prospective trials have shown that patients undergoing chemotherapy do display impairment in specific cognitive domains. Aging confers an increased risk of developing cancer, as well as cognitive impairment. The Geriatric Oncology clinic of the Segal Cancer Centre, Jewish General Hospital in Montreal was founded in 2006 to address the unique needs of older cancer patients. We will describe two cases of cancer therapy-related cognitive impairment from our Geriatric Oncology clinic. The first case is that of a 75 year old male diagnosed with stage III non-small cell lung carcinoma who complained of forgetfulness since starting carboplatin-paclitaxel. The second case is that of a 65 year old female diagnosed with stage I, estrogen-receptor-positive breast cancer who had undergone lumpectomy followed by adjuvant cyclophosphamide, methotrexate and fluorouracil chemotherapy, radiation therapy and was on exemestane when she was evaluated. We will also briefly review the literature of cancer therapy-related cognitive impairment.

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“…Varying levels of impairment have been found in concentration, working memory, processing speed, and other higher level cognitive abilities[9, 10]. Importantly, cognitive complaints and deficits are measurable even before adjuvant treatment[3, 6, 9, 11–13]. Furthermore, cognitive symptoms and fatigue have been shown to co-occur and may be cumulative over time, suggesting they may share common pathogenic mechanisms[14, 15].…”

Section: Introductionmentioning

confidence: 99%

Neuromarkers of fatigue and cognitive complaints following chemotherapy for breast cancer: a prospective fMRI investigation

Askren

Jung

Berman

et al. 2014

Breast Cancer Res Treat

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PURPOSE To use functional magnetic resonance imaging (fMRI) to prospectively examine pre-treatment predictors of post-treatment fatigue and cognitive dysfunction in women treated with adjuvant chemotherapy for breast cancer. Fatigue and cognitive dysfunction often co-occur in women treated for breast cancer. We hypothesized that pre-treatment factors, unrelated to chemotherapy per se, might increase vulnerability to post-treatment fatigue and cognitive dysfunction. METHODS Patients treated with (n=28) or without chemotherapy (n=37) and healthy controls (n=32) were scanned coincident with pre- and one-month-post-chemotherapy during a verbal working memory task (VWMT) and assessed for fatigue, worry, and cognitive dysfunction. fMRI activity measures in the frontoparietal executive network were used in multiple linear regression to predict post-treatment fatigue and cognitive function. RESULTS The chemotherapy group reported greater pre-treatment fatigue than controls and showed compromised neural response characterized by higher spatial variance in executive network activity than the non-chemotherapy group. Also, the chemotherapy group reported greater post-treatment fatigue than the other groups. Linear regression indicated that pre-treatment spatial variance in executive network activation predicted post-treatment fatigue severity and cognitive complaints, while treatment group, age, hemoglobin, worry, and mean executive network activity levels did not predict these outcomes. CONCLUSIONS Pre-treatment neural inefficiency (indexed by high spatial variance) in the executive network, which supports attention and working memory, was a better predictor of post-treatment cognitive and fatigue complaints than exposure to chemotherapy per se. This executive network compromise could be a pre-treatment neuromarker of risk, indicating patients most likely to benefit from early intervention for fatigue and cognitive dysfunction.

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A prospective evaluation of cognitive function in patients with early breast cancer receiving adjuvant chemotherapy

Cited by 5 publications

References 0 publications

Systematic review of longitudinal studies on chemotherapy‐associated subjective cognitive impairment in cancer patients

Systematic review of longitudinal studies on chemotherapy‐associated subjective cognitive impairment in cancer patients

The impact of cancer therapy on cognition in the elderly

Neuromarkers of fatigue and cognitive complaints following chemotherapy for breast cancer: a prospective fMRI investigation

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