Association between chemotherapy and cognitive impairments in a large cohort of patients with colorectal cancer
Association between chemotherapy and cognitive impairments in a large cohort of patients with colorectal cancer
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DOI：
10.3892/ijo.2013.1882
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发表时间：
2013-06-01
影响因子：
5.2
通讯作者：
Symanski, Elaine
中科院分区：
文献类型：
--
作者：
Du, Xianglin L.;Cai, Yi;Symanski, Elaine
目前还没有关于化疗与结直肠癌患者认知障碍风险之间关系的基于人群的研究。本研究旨在确定一个基于大人群的患者队列中的这种相关性。我们研究了1991年至2002年来自16个地区的72，374名年龄≥ 65岁的诊断为I-III期结直肠癌的男性和女性，他们在监测，流行病学和最终结果项目中基线时没有认知障碍。随访17年，并根据接受化疗的倾向研究了15，921个匹配的队列。化疗组5年时药物性痴呆的累积发生率为每1，000人16.2例，未化疗组为每1，000人12.4例。总体而言，在调整患者和肿瘤特征后，接受化疗的患者发生药物性痴呆的可能性比未接受化疗的患者高24%（风险比1.24，95%置信区间1.05-1.47）。仅在整个队列（1.26，1.06-1.50）和匹配队列（1.29，1.04-1.59）中接受化疗的无情绪障碍患者中观察到风险显著增加。与未接受化疗的患者相比，接受化疗的患者患阿尔茨海默病、血管性痴呆或其他痴呆症的风险显著降低，无论情绪障碍状态如何。总之，化疗与无情绪障碍的结直肠癌患者发生药物性痴呆的风险之间存在显著相关性，但化疗与其他痴呆风险降低相关。
No population-based study has been conducted on the relationship between chemotherapy and the risk of cognitive impairments in patients with colorectal cancer. This study aimed to determine this association in a large population-based cohort of patients. We studied 72,374 men and women who were diagnosed with stages I-III colorectal cancer at age >= 65 years from 1991 through 2002 from 16 regions in the Surveillance, Epidemiology and End Results program who were free of cognitive impairments at baseline with up. to 17 years of follow-up and also studied 15,921 matched cohorts based on the propensity of receiving chemotherapy. The cumulative incidence of drug-induced dementia at 5 years was 16.2 cases per 1,000 persons for the chemotherapy group and 12.4 cases per 1,000 persons for the no chemotherapy group. Overall, patients who received chemotherapy were 24% significantly more likely to develop drug-induced dementia compared to those without chemotherapy after adjusting for patient and tumor characteristics (hazard ratio 1.24, 95% confidence interval 1.05-1.47). The significantly increased risk was only observed in those without mood disorder who received chemotherapy in the entire cohort (1.26, 1.06-1.50) and in the matched cohort (1.29, 1.04-1.59). The risk of developing Alzheimer's disease, vascular dementia or other dementias was significantly lower in patients receiving chemotherapy compared to those without chemotherapy regardless of mood disorder status. In conclusion, there was a significant association between chemotherapy and the risk of developing drug-induced dementia in patients with colorectal cancer without mood disorder, but chemotherapy was associated with a decreased risk of other dementias.