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乳腺癌幸存者化疗后记忆缺陷分析:来自门和人测试的证据。

Analysis of memory deficits following chemotherapy in breast cancer survivors: evidence from the doors and people test.

机构信息

Department of Social Work, Ben Gurion University of the Negev, Beer Sheva, Israel.

出版信息

J Psychosoc Oncol. 2011;29(5):499-514. doi: 10.1080/07347332.2011.600751.

Abstract

Studies of cognitive effects of chemotherapy among breast cancer patients show that not all women who are exposed to chemotherapy develop cognitive dysfunction and that the observed declines in cognitive functioning may be quite subtle. The use of measures that are sensitive to subtle cognitive decline are recommended yet rarely used among clinical populations. The purpose of this study is to specify the types of memory changes observed among breast cancer survivors treated with chemotherapy and tamoxifen, by using an analytic test of memory, the Doors and People test, which uses age-adjusted norms. The participants were 40 women who were survivors of breast cancer, 20 of whom had completed chemotherapy treatment and 20 women who were treated only with tamoxifen. There were no significant differences between the two groups in overall scores and in all four subtests: visual memory, verbal memory, recall, and recognition measured by age-adjusted scores. Forty percent of patients in both of the groups were classified as having mild impairment in episodic memory. No between-group differences were found in the frequency of subjective, cognitive complaints. Subjective complaints were reported by 69% of patients but were unrelated to objective performance. Memory deficits were observed in breast cancer patients who receive either chemotherapy or tamoxifen alone compared to age-adjusted norms. The Doors and People Test is a sensitive measure of memory deficits that is feasible for use with clinical populations of breast cancer patients in order to monitor changes in cognitive function.

摘要

针对乳腺癌患者化疗认知效应的研究表明,并非所有接受化疗的女性都会出现认知功能障碍,而且观察到的认知功能下降可能非常细微。建议使用对细微认知下降敏感的测量方法,但在临床人群中很少使用。本研究的目的是使用门和人测试(Doors and People test)这种分析性记忆测试来明确接受化疗和他莫昔芬治疗的乳腺癌幸存者所观察到的记忆变化类型,该测试使用年龄调整后的标准。参与者为 40 名乳腺癌幸存者,其中 20 名接受过化疗治疗,20 名仅接受他莫昔芬治疗。两组在总分和所有四个子测试(视觉记忆、言语记忆、回忆和识别)方面的年龄调整分数上均无显著差异。两组中有 40%的患者被归类为存在轻度情景记忆障碍。在主观认知抱怨的频率上,两组之间没有差异。69%的患者报告了主观抱怨,但与客观表现无关。与年龄调整标准相比,单独接受化疗或他莫昔芬治疗的乳腺癌患者存在记忆缺陷。门和人测试是一种敏感的记忆缺陷测量方法,可用于监测乳腺癌患者的认知功能变化,适用于临床人群。

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