Hurria Arti, Lachs Mark
City of Hope, Duarte, CA 91010, USA.
Breast Cancer Res Treat. 2007 Jul;103(3):259-68. doi: 10.1007/s10549-006-9383-9. Epub 2007 Apr 12.
For a number of years, patients have anecdotally reported changes in memory and concentration problems after receiving chemotherapy for breast cancer. Neuropsychological studies have been performed to seek objective evidence as to the existence and extent of this phenomenon; however, these studies were primarily performed in younger women and there is sparse data regarding the impact of adjuvant chemotherapy on an older woman's cognition. The objective of this paper was to evaluate the current literature in order to propose ways to overcome methodological limitations of studies to consider whether chemotherapy-associated cognitive dysfunction exists in older patients and if so, who is at risk. A systematic review of relevant literature was performed including study design, mean age of participants, treatment received, neuropsychological tests employed, timing of assessments, definition of cognitive impairment, and results. The literature primarily consists of small studies, which lack a prospective longitudinal design, vary in design measures, and exclude older patients who are at greatest risk for cognitive impairment. Since aging is the number one risk factor for breast cancer, future studies of the neuropsychological impact of chemotherapy should include older patients.
多年来，患者一直有轶事报道称，在接受乳腺癌化疗后出现了记忆力变化和注意力不集中的问题。已经开展了神经心理学研究，以寻找关于这一现象的存在及程度的客观证据；然而，这些研究主要是在年轻女性中进行的，关于辅助化疗对老年女性认知影响的数据很少。本文的目的是评估当前的文献，以便提出克服研究方法局限性的方法，来考虑老年患者中是否存在化疗相关的认知功能障碍，如果存在，哪些人有风险。我们对相关文献进行了系统综述，内容包括研究设计、参与者的平均年龄、接受的治疗、采用的神经心理学测试、评估时间、认知障碍的定义以及结果。文献主要由一些小型研究组成，这些研究缺乏前瞻性纵向设计，设计方法各不相同，并且排除了认知障碍风险最大的老年患者。由于衰老是乳腺癌的首要风险因素，未来关于化疗对神经心理学影响的研究应纳入老年患者。
