Clinical Cancer Epidemiology, Sahlgrenska Academy at University of Gothenburg, Sweden.
Acta Oncol. 2012 Feb;51(2):185-97. doi: 10.3109/0284186X.2011.602113. Epub 2011 Aug 18.
Studies suggest an increased risk for compromised cognitive function among cancer survivors. It is unclear to what extent chemotherapy is the cause and how the dysfunction, when present, affects everyday life. The objective was to study self-reported behaviours that may depend on cognitive function, among testicular-cancer survivors who received various cycles of cisplatin-based chemotherapy by comparing them with those who did not.
We identified 1173 eligible men diagnosed with non-seminomatous testicular cancer treated according to the national cancer-care programs SWENOTECA I-IV between 1981 and 2004. During an 18-month qualitative phase we constructed a study-specific questionnaire including questions about specific activities and behaviour in everyday life.
We obtained information from 960 of 1173 (82%) testicular-cancer survivors diagnosed on average 11 years previously. The prevalence of "saying similar but incorrect words" at least once a week was 5% among those having received no chemotherapy versus 16% among those having received five or more cycles, giving a prevalence ratio ("relative risk", RR) of 3.3 with a 95% confidence interval of 1.5 to 7.1. The corresponding figure for "saying words in the wrong order" was 3.1 (1.7-5.8), for "difficulties understanding what other people mean" 3.1 (1.3-7.7), for "saying words other than planned" 2.2 (1.1-4.5) and for "difficulties completing sentences" 2.0 (1.0-3.6). The relative risks for those with a low level of education ranged between 4.9 (1.6-14.9) and 15.3 (1.9-120.5).
Testicular-cancer survivors in Sweden who have received five or more cycles of cisplatin-based chemotherapy experience an increased incidence of long-term compromised language; the effect is primarily seen among men with a low level of education.
研究表明，癌症幸存者认知功能受损的风险增加。尚不清楚化疗在多大程度上是导致这种功能障碍的原因，以及当功能障碍存在时，它会如何影响日常生活。本研究旨在通过比较接受过不同周期顺铂为基础的化疗的睾丸癌幸存者和未接受化疗的幸存者，研究可能依赖于认知功能的自我报告行为。
我们确定了 1981 年至 2004 年期间根据国家癌症护理计划 SWENOTECA I-IV 治疗的 1173 名非精原细胞瘤睾丸癌患者。在 18 个月的定性阶段，我们构建了一个特定于研究的问卷，其中包括日常生活中特定活动和行为的问题。
我们从 1173 名睾丸癌幸存者中的 960 名（82%）获得了信息，这些幸存者平均在 11 年前被诊断出患有疾病。在未接受化疗的患者中，每周至少说一次“类似但不正确的词”的患病率为 5%，而在接受 5 个或更多周期化疗的患者中，患病率为 16%，患病率比（“相对风险”，RR）为 3.3，95%置信区间为 1.5 至 7.1。对于“用词不当”，相应的数字为 3.1（1.7-5.8），对于“难以理解他人的意思”为 3.1（1.3-7.7），对于“说出非计划中的词语”为 2.2（1.1-4.5），对于“难以完成句子”为 2.0（1.0-3.6）。教育程度较低的患者的相对风险范围在 4.9（1.6-14.9）到 15.3（1.9-120.5）之间。
瑞典接受过 5 个或更多周期顺铂为基础的化疗的睾丸癌幸存者经历了长期语言功能受损的发生率增加；这种影响主要见于教育程度较低的男性。
