A metaanalysis of studies of the effects of cancer chemotherapy on various domains of cognitive function
A metaanalysis of studies of the effects of cancer chemotherapy on various domains of cognitive function
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DOI：
10.1002/cncr.21469
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发表时间：
2005-11-15
期刊：
影响因子：
6.2
通讯作者：
Kramer, J
中科院分区：
文献类型：
--
作者：
Jansen, CE;Miaskowski, C;Kramer, J
背景关于化疗对认知功能的影响知之甚少。本荟萃分析的目的是估计化疗对认知功能各领域影响的效应量，并通过每种效应比较方法（即，标准数据、对照组或基线数据）。本研究纳入了16项评价化疗患者认知功能的研究。使用DSTAT荟萃分析软件计算每个神经心理学测试的效应量和置信区间。测试被分配到一个特定的认知领域，并确定每个领域的平均效应量。只有一个认知功能域（即，视觉记忆）在所有比较类型中具有显著的化疗诱导的损伤。然而，当化疗患者的神经心理学测试分数与正常数据进行比较时，在认知功能的四个领域（即，执行功能、信息处理速度、文字记忆、视觉记忆）。此外，当化疗患者的测试分数与健康对照组的测试分数进行比较时，发现语言和非文字记忆的效应量显著，尽管很小。所有显著的平均效应量均为负向，表明接受化疗患者的神经心理学测试平均得分均低于对照组。这项荟萃分析的数据支持化疗对认知功能有负面影响的假设。然而，本研究中的大多数缺陷范围从小到中等，并且不显著。
BACKGROUND. Little is known about the effects of chemotherapy on cognitive function. The purposes of this metaanalysis were to estimate the effect sizes for the effect of chemotherapy on each domain of cognitive function and to differentiate effect sizes by each method of comparison of effects (i.e., normative data, control group, or baseline data).METHODS. Sixteen studies that evaluated cognitive function in chemotherapy patients were included in the study. DSTAT metaanalysis software was used to calculate an effect size and confidence intervals for each neuropsychologic test. Tests were assigned to a specific cognitive domain, and an average effect size was determined for each domain.RESULTS. Only one domain of cognitive function (i.e., visual memory) had significant chemotherapy-induced impairment across all comparison types. However, when the neuropsychologic test scores of chemotherapy patients were compared with normative data, significant effect sizes were found for four domains of cognitive function (i.e., executive function, information processing speed, verbal memory, visual memory). In addition, significant, albeit small, effect sizes were found for language and verbal memory when chemotherapy patients' test scores were compared with test scores of healthy matched controls. All significant averaged effect sizes were in the negative direction, indicating that mean scores on neuropsychologic tests for patients who had received chemotherapy were on average lower than comparison scores.CONCLUSION. Data from this metaanalysis supported the hypothesis that chemotherapy can have a negative impact on cognitive function. However, most deficits in this study ranged from small to moderate and were nonsignificant.