A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients (original) (raw)

Abstract

Purpose

Evidence for chemotherapy-induced cognitive impairment remains inconclusive. This study was designed to determine the trajectory of cognitive function over time in women with breast cancer, who received doxorubicin and cyclophosphamide (AC) alone or followed by a taxane. Associations between changes in cognitive function and potential covariates including anxiety, depression, fatigue, hemoglobin level, menopausal status, and perception of cognitive function were evaluated.

Methods

The Repeatable Battery for the Assessment of Neuropsychological Status, Stroop Test, and Grooved Pegboard were used to assess cognitive function in a group of 71 women prior to chemotherapy, a week after completing the last cycle of AC, as well as 1 week and 6 months after the completion of all chemotherapy.

Results

Cognitive impairment was found in 23% of women prior to chemotherapy. Hierarchical linear modeling showed significant decreases after receiving chemotherapy followed by improvements 6 months after the completion of chemotherapy in the cognitive domains of visuospatial skill (p < 0.001), attention (p = 0.022), delayed memory (p = 0.006), and motor function (p = 0.043). In contrast, immediate memory, language, and executive function scores did not change over time.

Conclusion

These results suggest that having a breast cancer diagnosis may be associated with cognitive impairment. While chemotherapy may have a negative impact on cognitive function, chemotherapy-related impairments appear to be more acute than chronic side effects of therapy. Further studies are needed to provide insight into the clinical significance and potential mechanisms of cancer and treatment-related cognitive impairments.

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Acknowledgement

We would like to acknowledge that Dr. Jansen was supported by the American Cancer Society Doctoral Scholarship in Cancer Nursing (no. 02-209-03) and a grant from the Oncology Nursing Society Foundation. Drs. Cooper, Dodd, and Miaskowski are supported by grants from the National Cancer Institute and the National Institute of Nursing Research.

Conflict of interest

None of the authors have any conflicts to disclose.

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Authors and Affiliations

  1. Kaiser Permanente Medical Center, 2238 Geary Blvd., Room 8E343, San Francisco, CA, 94115, USA
    Catherine E. Jansen
  2. Department of Community Health Systems, University of California, San Francisco, USA
    Bruce A. Cooper
  3. Department of Physiological Nursing, University of California, San Francisco, USA
    Marylin J. Dodd & Christine A. Miaskowski

Authors

  1. Catherine E. Jansen
  2. Bruce A. Cooper
  3. Marylin J. Dodd
  4. Christine A. Miaskowski

Corresponding author

Correspondence toCatherine E. Jansen.

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Jansen, C.E., Cooper, B.A., Dodd, M.J. et al. A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients.Support Care Cancer 19, 1647–1656 (2011). https://doi.org/10.1007/s00520-010-0997-4

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