Cognitive Effects of Cancer Chemotherapy

申请人描述：与癌症治疗相关的认知缺陷 可以对患者的生活质量产生巨大影响， 被总统癌症小组（1999年）和国家癌症中心（1999年）认为是一个问题。 癌症生存联盟是癌症患者面临的挑战。的 本申请是由本领域的研究人员完成的工作的扩展， 达特茅斯与癌症幸存者办公室的补充诺里斯 棉花癌症中心核心补助金（补助金编号：P30CA23 108，增补）， 全身化疗对乳腺癌长期存活者的认知影响 癌症和淋巴瘤。“诊断后5年以上的幸存者 和无病者进行了一系列标准化的神经心理学检查， 和心理测试。结果表明，幸存者谁已经 接受全身化疗的患者总体得分显著降低， 与接受治疗的幸存者相比， 只接受局部治疗在下一阶段的研究中，我们建议 前瞻性研究乳腺癌患者的认知缺陷， 接受第一个疗程全身化疗的淋巴瘤患者 与局部手术或非中枢神经系统放疗相比。将对患者进行评估， 治疗前和诊断后6个月、12个月和24个月， 神经心理学和心理学测试。主要假设 接受全身化疗的患者 从治疗前到治疗后标准化措施的业绩下降 神经心理学功能与接受局部 只有在控制了重要的混杂变量如年龄， 教育和心理状态。其次，我们将评估 认知功能和其他可能影响 癌症患者的认知，包括遗传标记（APOE状态）、代谢 因素、绝经状态（诊断时绝经前与绝经后）和使用 他莫昔芬（仅乳腺癌）。

APPLICANT'S DESCRIPTION: Cognitive deficits associated with cancer treatment can have a dramatic effect on patients' quality of life and have been recognized as a problem by the President's Cancer Panel (1999) and the National Coalition for Cancer Survivorship as a challenge facing people with cancer. The present application is an extension of work completed by researchers at Dartmouth with a supplement from the Office of Cancer Survivors to the Norris Cotton Cancer Center Core grant (Grant No. P30CA23 108, supplement) entitled "Cognitive Impact of Systemic Chemotherapy in Long-Term Survivors of Breast Cancer and Lymphoma." Survivors who were greater than 5 years post-diagnosis and disease free were administered a battery of standardized neuropsychological and psychological tests. The results demonstrated that survivors who had been treated with systemic chemotherapy scored significantly lower in overall neuropsychological functioning as compared to survivors who had been treated with local therapy only. In this next phase of research, we propose to prospectively study the cognitive deficits experienced by breast cancer and lymphoma patients treated with their first course of systemic chemotherapy versus local surgery or non-CNS radiation. Patients will be assessed at pre-treatment and 6, 12 and 24 months post-diagnosis with a standardized battery of neuropsychological and psychological tests. The primary hypothesis is that patients treated with systemic chemotherapy will demonstrate greater decrements in performance from pre- to post-treatment on standardized measures of neuropsychological functioning as compared to patients treated with local therapy only after controlling for important confounding variables such as age, education, and psychological state. Secondarily, we will evaluate the associations between cognitive functioning and other factors that may effect cognition in cancer patients including genetic markers (APOE status), metabolic factors, menopausal status (pre- vs. post-menopausal at diagnosis), and use of tamoxifen (breast cancer only).