Stewart Angela, Collins Barbara, Mackenzie Joyce, Tomiak Eva, Verma Shailendra, Bielajew Catherine
School of Psychology, University of Ottawa, Ottawa, Ont., Canada.
Psychooncology. 2008 Feb;17(2):122-30. doi: 10.1002/pon.1210.
The primary purpose of this study was to evaluate the cognitive effects of adjuvant chemotherapy in post-menopausal breast cancer patients.
Breast cancer patients scheduled to receive adjuvant chemotherapy (n = 61) completed comprehensive cognitive testing before and after treatment. A control group of women receiving adjuvant hormonal therapy (n = 51) was tested at comparable intervals.
Mean scores for both patient groups were within the normal range relative to published norms on all cognitive tests at both time points, and generally inclined or stayed the same from baseline to retest in both groups. However, in an analysis of individual change scores, the chemotherapy patients were 3.3 times more likely than the hormonal patients to show reliable cognitive decline (31 and 12%, respectively). Chemotherapy subjects showing decline were less educated and had higher baseline depression scores than their counterparts who did not decline. Working memory was the cognitive domain most vulnerable to the effects of chemotherapy.
These data support previous findings of a subtle negative influence of chemotherapy on cognitive function in a subgroup of breast cancer patients. The results are discussed in terms of the importance of study design.
本研究的主要目的是评估辅助化疗对绝经后乳腺癌患者认知功能的影响。
计划接受辅助化疗的乳腺癌患者（n = 61）在治疗前后完成了全面的认知测试。接受辅助激素治疗的女性对照组（n = 51）在相似的时间间隔进行测试。
在两个时间点的所有认知测试中，相对于已发表的常模，两组患者的平均得分均在正常范围内，且两组从基线到复测时总体呈上升趋势或保持不变。然而，在对个体变化得分进行分析时，化疗患者出现可靠认知下降的可能性是激素治疗患者的3.3倍（分别为31%和12%）。出现认知下降的化疗受试者比未出现下降的受试者受教育程度更低，基线抑郁得分更高。工作记忆是最易受化疗影响的认知领域。
这些数据支持了先前关于化疗对一部分乳腺癌患者认知功能有微妙负面影响的研究结果。从研究设计的重要性方面对结果进行了讨论。
