Cognitive effects of hormonal therapy in early stage breast cancer patients: a prospective study
Cognitive effects of hormonal therapy in early stage breast cancer patients: a prospective study
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DOI：
10.1002/pon.1453
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发表时间：
2009-08-01
期刊：
影响因子：
3.6
通讯作者：
Verma, Shailendra
中科院分区：
文献类型：
--
作者：
Collins, Barbara;Mackenzie, Joyce;Verma, Shailendra
目的：探讨激素辅助治疗对乳腺癌患者认知功能的影响。参与者和方法：接受三苯氧胺(n=31)或阿那曲唑(n=14)治疗的绝经后乳腺癌患者在治疗开始时(T1)和5-6个月后(T2)分别进行神经心理测试。健康女性志愿者(n=28)的样本以相同的时间间隔进行测试。采用基于标准化回归的方法来评估认知变化。该方法使用健康对照组的测试/重测分数来生成从T1分数预测T2分数的方程。结果：个体偏差得分分析显示，服用他莫昔芬和服用阿那曲唑的患者比健康对照组更有可能出现从T1到T2的可靠认知下降(分别为39，和7%)。加工速度和言语记忆是受影响最大的认知领域。结论：这些数据表明激素治疗对乳腺癌患者的认知产生了微妙的负面影响。进一步的分析表明，人口因素或疲劳并不能完全解释这种影响。讨论了当前研究的方法局限性，并对这一领域的未来研究提出了建议。版权所有(C)2008 John Wiley&Sons，Ltd.
Objective: The primary purpose of this study was to evaluate the cognitive effects of adjuvant hormonal therapies in breast cancer patients.Participants and Methods: Post-menopausal breast cancer patients scheduled to receive tamoxifen (n = 31) or anastrozole (n = 14) completed neuro psychological testing around the time of commencement of treatment (T1), and again 5-6 months later (T2). A sample of healthy female volunteers (n = 28) was tested at comparable intervals. A standardized regression-based approach was used to assess cognitive change. This method uses test/retest scores of the healthy control group to generate an equation that predicts T2 scores from T1 scores. The difference between the predicted and obtained T2 scores divided by the standard error of the estimate produces a deviation score that reflects the discrepancy from the T1-T2 difference scores that would be expected on the basis of practice and error alone.Results: Analysis of individual deviation scores revealed that both the patients taking tamoxifen and those taking anastrozole were more likely than healthy controls to show reliable cognitive decline from T1 to T2 (39, 64, and 7%, respectively). Processing speed and verbal memory were the cognitive domains most affected.Conclusion: These data suggest that hormonal therapies exert a subtle negative influence on cognition in breast cancer patients. Further analyses indicated that this effect was not fully accounted for by demographic factors or fatigue. Methodological limitations of the current study are addressed, along with recommendations for future studies in this area. Copyright (C) 2008 John Wiley & Sons, Ltd.