Ando-Tanabe Noriko, Iwamitsu Yumi, Kuranami Masaru, Okazaki Shigemi, Yasuda Hiroe, Nakatani Yuki, Yamamoto Kenji, Watanabe Masahiko, Miyaoka Hitoshi
Department of Medical Psychology, Pharmaceutical Education Research Center, Kitasato University School of Pharmacy, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan,
Breast Cancer. 2014 Jul;21(4):453-62. doi: 10.1007/s12282-012-0405-7. Epub 2012 Sep 14.
The aim of this study was to evaluate the impact of chemotherapy and psychological distress on cognitive function in patients with breast cancer receiving chemotherapy compared to healthy controls.
Eighteen women with non-metastatic breast cancer who have been exposed to chemotherapy were evaluated with a battery of neuropsychological and psychological tests before (time 1) and 1 month after chemotherapy (time 2). Twenty healthy women were assessed at matched intervals.
The relationship between cognitive change and mood change from time 1 to time 2 was compared between breast cancer patients and healthy controls. Independent t tests revealed no differences in change scores for each neuropsychological test and psychological questionnaire between the chemotherapy and control groups. However, in the chemotherapy group, change scores for verbal memory test and executive function test were significantly and negatively correlated with change score for Hospital Anxiety and Depression Scale (HADS)-D (r ≤ -0.498, p < 0.05). Furthermore, change scores for the verbal memory test and processing function test were also significantly and negatively correlated with change score for HADS-A (r ≤ -0.503, p < 0.05). The multiple regression model for the processing function test accounted for a significant amount of variance (model adjusted R (2) = 0.157, p < 0.05), where the standard partial regression coefficient for HADS-A change score was statistically significant (β = -0.441, p < 0.01), whereas the standard partial regression coefficients for the group and for the HADS-D change score were -0.297 (p = 0.071) and 0.026 (p = 0.868), respectively.
Higher psychological distress was associated with poor cognitive function in patients receiving chemotherapy in this study.
本研究旨在评估与健康对照组相比,化疗和心理困扰对接受化疗的乳腺癌患者认知功能的影响。
对18名接受过化疗的非转移性乳腺癌女性患者在化疗前(时间1)和化疗后1个月(时间2)进行了一系列神经心理学和心理测试评估。20名健康女性在相匹配的时间间隔接受评估。
比较了乳腺癌患者和健康对照组从时间1到时间2认知变化与情绪变化之间的关系。独立t检验显示,化疗组和对照组在每项神经心理学测试和心理问卷的变化得分上没有差异。然而,在化疗组中,言语记忆测试和执行功能测试的变化得分与医院焦虑抑郁量表(HADS)-D的变化得分显著负相关(r≤-0.498,p<0.05)。此外,言语记忆测试和处理功能测试的变化得分也与HADS-A的变化得分显著负相关(r≤-0.503,p<0.05)。处理功能测试的多元回归模型解释了显著的方差量(模型调整R(2)=0.157,p<0.05),其中HADS-A变化得分的标准偏回归系数具有统计学意义(β=-0.441,p<0.01),而组和HADS-D变化得分的标准偏回归系数分别为-0.297(p=0.071)和0.026(p=0.868)。
在本研究中,接受化疗的患者心理困扰程度越高,认知功能越差。