Fan H G Mar, Park A, Xu W, Yi Q-L, Braganza S, Chang J, Couture F, Tannock I F
Princess Margaret Hospital and University of Toronto, Toronto, Ontario, Canada.
Psychooncology. 2009 Feb;18(2):156-61. doi: 10.1002/pon.1372.
Cognitive dysfunction is a potential side effect of chemotherapy, and erythropoietin might be protective. A previously reported study compared quality-of-life in women undergoing chemotherapy for breast cancer who were randomized to receive epoetin-alpha or standard care. Here, we report a non-randomized sub-study in which cognitive function of participants was evaluated at 12-30 months after chemotherapy.
The primary endpoint was the proportion of women with moderate-severe cognitive impairment, as measured by the High Sensitivity Cognitive Screen (HSCS). Subjects also completed the Revised Hopkins Verbal Learning Test (HVLT-R), the Functional Assessment of Cancer Therapy--Fatigue (FACT-F) and FACT-G self-report questionnaires for fatigue and quality-of-life, and the Hospital Anxiety and Depression Scale.
Of 278 patients receiving adjuvant treatment in the primary study, 87 participated in the sub-study: 45 had received epoetin-alpha and 42 standard care. Groups were well matched for age and type of chemotherapy. Eight patients (9%) had moderate-severe cognitive dysfunction by the HSCS: six of them in the epoietin-alpha group (not significant). There were no significant differences in the HVLT-R, or in fatigue, but patients who had received epoetin-alpha reported better quality-of-life.
This study failed to demonstrate a protective effect of epoetin-alpha against the development of delayed cognitive dysfunction after chemotherapy.
认知功能障碍是化疗的一种潜在副作用,而促红细胞生成素可能具有保护作用。一项先前报道的研究比较了随机接受促红细胞生成素α或标准护理的乳腺癌化疗女性的生活质量。在此,我们报告一项非随机子研究,其中在化疗后12 - 30个月评估参与者的认知功能。
主要终点是通过高敏认知筛查(HSCS)测量的中重度认知障碍女性的比例。受试者还完成了修订的霍普金斯言语学习测试(HVLT - R)、癌症治疗功能评估 - 疲劳(FACT - F)以及用于疲劳和生活质量的FACT - G自我报告问卷,以及医院焦虑抑郁量表。
在主要研究中接受辅助治疗的278例患者中,87例参与了子研究:45例接受促红细胞生成素α治疗,42例接受标准护理。两组在年龄和化疗类型方面匹配良好。通过HSCS评估,8例患者(9%)存在中重度认知功能障碍:其中6例在促红细胞生成素α组(无统计学意义)。在HVLT - R或疲劳方面无显著差异,但接受促红细胞生成素α治疗的患者报告生活质量更好。
本研究未能证明促红细胞生成素α对化疗后延迟性认知功能障碍的发生具有保护作用。