Department of Pharmacy, National University of Singapore, Singapore.
Crit Rev Oncol Hematol. 2012 Jul;83(1):99-111. doi: 10.1016/j.critrevonc.2011.09.001. Epub 2011 Oct 19.
Post-chemotherapy cognitive impairment has been an issue of concern in cancer survivors. While most reviews are focused on patient-related factors, it is proposed that drug-related factors may also be determinants. The objective of this review is to study the relationship between the types and dose intensities of chemotherapy regimens on cognitive impairment in breast cancer patients through a systematic literature search. Eighteen prospective studies were selected. The types, dose intensities and durations of chemotherapy regimens received by subjects were compared against prevalence results obtained in individual studies. It was observed that the duration of impairment varied across different generations of chemotherapy regimens. Concurrent administration of multiple cytotoxic agents can lead to a synergistic decline on cognition. Current clinical evidence is insufficient to evaluate the relationship between the types, dose intensities of chemotherapy regimens and cognitive impairment. More investigation is needed to examine the role of pharmacological factors in chemotherapy-associated cognitive changes.
化疗后认知障碍一直是癌症幸存者关注的问题。虽然大多数综述都集中在与患者相关的因素上，但有人提出，药物相关因素也可能是决定因素。本综述的目的是通过系统的文献检索，研究乳腺癌患者化疗方案的类型和剂量强度与认知障碍之间的关系。选择了 18 项前瞻性研究。比较了受试者接受的化疗方案的类型、剂量强度和持续时间与个别研究中获得的患病率结果。结果观察到，不同代化疗方案的损害持续时间不同。同时使用多种细胞毒性药物会导致认知功能协同下降。目前的临床证据还不足以评估化疗方案的类型和剂量强度与认知障碍之间的关系。需要进一步研究来检查药理学因素在化疗相关认知变化中的作用。
