Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma
Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma
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DOI：
10.1200/jco.2002.20.2.485
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发表时间：
2002-01-15
影响因子：
45.3
通讯作者：
Silberfarb, PM
中科院分区：
文献类型：
--
作者：
Ahles, TA;Saykin, AJ;Silberfarb, PM
目的：本研究的主要目的是比较接受标准剂量全身化疗或仅局部治疗的乳腺癌和淋巴瘤长期幸存者的神经心理功能。患者和方法：长期幸存者(5年！诊断后，目前未接受癌症治疗，无疾病)接受过全身化疗的乳腺癌或淋巴瘤，（乳腺癌：n = 35，年龄，59.1 +/- 10.7岁；淋巴瘤：n = 36，年龄，55.9 +/- 12.1岁）或局部治疗，仅(乳腺癌：n = 35，年龄，60.6 +/- 10.5岁；淋巴瘤：n = 22，年龄48.7±11.7岁)完成了一系列神经心理学和心理测试（流行病学研究中心-抑郁，Spielberger状态-特质焦虑量表和疲劳症状量表）。结果：多变量方差分析，控制年龄和受教育程度，显示接受全身化疗的幸存者在一系列神经心理测试中得分明显低于仅接受局部治疗的幸存者（P < .04），特别是在言语记忆（P < .01）和精神运动功能（P < .03）方面。接受全身化疗的幸存者也更有可能在神经心理表现指数（Neuropsychological Performance Index）上得分较低（39% vs 14%, P < 0.01），并在Squire记忆自评问卷上自我报告更大的工作记忆问题（P < 0.02）。结论：本研究的数据支持这样的假设，即通过标准化的神经心理学测试和记忆变化的自我报告来衡量，全身化疗可能对认知功能产生负面影响。然而，神经心理学表现指数的分析表明，只有一小部分幸存者可能经历与全身化疗相关的长期认知缺陷。(C) 2002年由美国临床肿瘤学会出版。
Purpose : The primary purpose of this study was to compare the neuropsychologic functioning of long-term survivors of breast cancer and lymphoma who had: been treated with standard-dose systemic chemotherapy or local therapy only.Patients and Methods: Long-term survivors (5 years! postdiagnosis, not presently receiving cancer treatment, and disease-free) of breast cancer or lymphoma who had been treated with systemic chemotherapy, (breast cancer: n = 35, age, 59.1 +/- 10.7 years; lymphoma: n = 36, age, 55.9 +/- 12.1 years) or local therapy, only (breast cancer: n = 35, age, 60.6 +/- 10.5 years; lymphoma: n = 22, age, 48.7 +/- 11.7 years) completed a battery of neuropsychologic and psychologic tests (Center for Epidemiological Study-Depression, Spielberger State-Trait Anxiety Inventory, and Fatigue Symptom Inventory).Results: Multivariate analysis of variance, controlling for age and education, revealed that survivors who had been treated with systemic chemotherapy scored significantly lower an the battery of neuropsychologic tests compared with those treated with local therapy only (P < .04), particularly in the domains of verbal memory (P < .01) and psychomotor functioning (P < .03). Survivors treated with systemic chemotherapy were also more likely to score in the lower quartile on the Neuropsychological Performance Index (39% v 14%, P < .01) and to self-report greater problems with working memory on the Squire Memory Self-Rating Questionnaire (P < .02).Conclusion: Data from this study support the hypothesis that systemic chemotherapy can have a negative impact on cognitive functioning as measured by standardized neuropsychologic tests and self-report of memory changes. However, analysis of the Neuropsychological Performance Index suggests that only a subgroup Of Survivors may experience long-term cognitive deficits associated with systemic chemotherapy. (C) 2002 by American Society of Clinical Oncology.