Cognitive Effects of Cancer Chemotherapy

申请人描述：与癌症治疗相关的认知缺陷 会对患者的生活质量产生巨大影响，而且一直以来 被总统癌症小组(1999)和国家癌症委员会认定为一个问题 癌症生存联盟是癌症患者面临的挑战。这个 本申请是研究人员在 达特茅斯，癌症幸存者办公室对诺里斯的补充 棉花癌症中心核心赠款(赠款编号：P30CA23 108，补编)，题为 “全身化疗对乳房长期存活者的认知影响 癌症和淋巴瘤：确诊后5年以上的幸存者 并且没有疾病的人接受了一系列标准化的神经心理学 和心理测试。结果表明，被杀的幸存者 接受全身化疗的患者总体得分明显较低 与接受治疗的幸存者的神经心理功能比较 只接受局部治疗。在下一阶段的研究中，我们建议 前瞻性研究乳腺癌和乳腺癌患者的认知缺陷 淋巴瘤患者的第一疗程全身化疗 而不是局部手术或非中枢神经系统放射治疗。患者将在以下时间接受评估 在治疗前和诊断后6、12和24个月使用标准化的 一系列神经心理和心理测试。主要假设 接受全身化疗的患者将表现出更大的 标准化措施的绩效从处理前到处理后的递减 与接受局部治疗的患者的神经心理功能进行比较 只有在控制了重要的混杂变量，如年龄， 教育，心理状态。其次，我们将评估 认知功能与其他可能影响 癌症患者对遗传标志物(APOE状态)、代谢的认知 因素、绝经状态(确诊时绝经前和绝经后)，以及使用 他莫昔芬(仅限乳腺癌)。

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).