Vandenbossche S, Fery P, Razavi D
Unité de psycho-oncologie et de psychosomatique, université libre de Bruxelles, 50 avenue F.D. Roosevelt, Brussels, Belgium.
Bull Cancer. 2009 Feb;96(2):239-48. doi: 10.1684/bdc.2008.0818.
Since the 1980's, women treated for breast cancer are reporting moderate cognitive impairments during and after chemotherapy. These cognitive impairments may be related to chemotherapy but also to hormone therapy, psychological distress, fatigue... This work is a critical review of the literature, which reports types of impairments, frequency, severity, causes and mechanisms involved in this issue. It also provides an update on potential moderators factors, which may be associated with mild cognitive impairments and various tools for their assessment used in the studies. These studies--selected between 1997 and 2008--show that cognitive impairments are frequently reported by patients with breast cancer but that the mechanisms are still poorly understood and that the methods of assessment are very heterogeneous and difficult to compare. This review indicates that future studies should include more homogenous patient groups, be longitudinal, use more sensitive and specific assessment tools and control moderators factors that play a role in impairment in cognitive function.
自20世纪80年代以来,接受乳腺癌治疗的女性报告称在化疗期间及化疗后存在中度认知障碍。这些认知障碍可能与化疗有关,但也与激素治疗、心理困扰、疲劳……有关。这项工作是对文献的批判性综述,报告了该问题所涉及的障碍类型、频率、严重程度、原因和机制。它还提供了关于潜在调节因素的最新信息,这些因素可能与轻度认知障碍有关,以及研究中用于评估它们的各种工具。这些在1997年至2008年间选取的研究表明,乳腺癌患者经常报告存在认知障碍,但机制仍知之甚少,评估方法非常多样且难以比较。这篇综述表明,未来的研究应纳入更同质的患者群体,采用纵向研究,使用更敏感和特异的评估工具,并控制在认知功能障碍中起作用的调节因素。