School of Medicine, Flinders Centre for Innovation in Cancer, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
Cancer Treat Rev. 2012 Nov;38(7):926-34. doi: 10.1016/j.ctrv.2012.05.002. Epub 2012 Jun 2.
Evidence suggests that some cancer survivors experience cognitive difficulties following chemotherapy. However, perceived or subjective cognitive impairment is more frequently reported than prevalence revealed by objective assessments. The aim of this review was to examine the relationship between subjective and objective measures of cognitive impairment following treatment for cancer and to determine the number of studies that found a significant relationship between these measures of cognition. A comprehensive search for articles, published between 1980 and 2012, comparing subjective and objective cognition in cancer patients treated with chemotherapy was conducted. Of 818 potentially relevant articles, 23 studies met the inclusion criteria for the current review and one article was sourced from reference lists of included studies. Only eight of 24 included studies found a significant relationship between objective and subjective measures of cognitive performance. These studies were more likely to involve breast cancer patients and to assess the relationship between memory and perceived cognitive impairment. The failure to consistently find an association between subjective and objective measures of cognition could be explained by variations in assessment methods or the definition of impairment. Alternatively, objective and perceived cognitive impairment may be unrelated because perceived impairment may be an indicator of psychological distress rather than cognitive impairment. Despite these discrepancies, patients' perceptions of impairment are important due to its significant impact on quality of life. Further research is required to explore whether objective measures of everyday functioning better predict the impact of chemotherapy related cognitive impairment on daily functioning.
有证据表明，一些癌症幸存者在接受化疗后会出现认知困难。然而，与客观评估显示的患病率相比，人们感知到或主观报告的认知障碍更为常见。本综述的目的是检查癌症治疗后主观和客观认知损伤之间的关系，并确定有多少研究发现这些认知测量之间存在显著关系。对 1980 年至 2012 年间发表的比较接受化疗的癌症患者主观和客观认知的文章进行了全面搜索。在 818 篇潜在相关文章中，有 23 篇符合本综述的纳入标准，另有一篇文章来源于纳入研究的参考文献列表。在 24 项纳入研究中，只有 8 项发现客观和主观认知表现测量之间存在显著关系。这些研究更可能涉及乳腺癌患者，并评估记忆和感知认知障碍之间的关系。主观和客观认知测量之间未发现一致的关联可能是由于评估方法或损伤定义的差异造成的。或者，客观和主观认知损伤可能没有关联，因为感知损伤可能是心理困扰的指标，而不是认知损伤。尽管存在这些差异，但患者对损伤的感知很重要，因为它对生活质量有重大影响。需要进一步研究来探讨日常功能的客观测量是否能更好地预测化疗相关认知损伤对日常功能的影响。
