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.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接受局部治疗的乳腺癌和淋巴瘤长期生存者的神经心理功能。确诊后，目前未接受癌症治疗，且无病)曾接受全身化疗的乳腺癌或淋巴瘤(乳腺癌35例，年龄59.1±10.7岁；淋巴瘤36例，年龄55.9±12.1岁)或仅接受局部治疗(乳腺癌35例，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学测试(流行病学研究中心抑郁、斯皮尔伯格状态-特质焦虑问卷和疲劳症状问卷)。结果：控制年龄和教育的多变量方差分析显示，接受全身化疗的幸存者在神经心理学测试中的得分显著低于仅接受局部治疗的患者(P<；.04)，特别是在语言记忆(P<；.01)和精神运动功能(P<；.03)领域。接受全身化疗的幸存者也更有可能在神经心理表现指数(39%vs14%，P<；.01)上获得较低的四分位分数，并在Squire Memory自评问卷(P<；.02)上自我报告工作记忆方面的更大问题。结论：本研究的数据支持这一假设，即通过标准化的神经心理测试和记忆变化的自我报告来衡量，全身化疗可以对认知功能产生负面影响。然而，对神经心理表现指数的分析表明，只有一部分幸存者可能会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提供。
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.