化疗和心理社会困扰对亚洲乳腺癌患者认知障碍感知的影响。

Effects of chemotherapy and psychosocial distress on perceived cognitive disturbances in Asian breast cancer patients.

机构信息

Department of Pharmacy, National University of Singapore.

出版信息

Ann Pharmacother. 2012 Dec;46(12):1645-55. doi: 10.1345/aph.1R408. Epub 2012 Dec 18.

DOI:10.1345/aph.1R408

PMID:23249868

Abstract

BACKGROUND

There is conflicting evidence on the effect of chemotherapy and psychosocial distress on perceived cognitive changes in cancer patients.

OBJECTIVE

To compare the severity of perceived cognitive disturbance in Asian breast cancer patients receiving chemotherapy and those not receiving chemotherapy, and identify clinical characteristics associated with perceived cognitive disturbances.

METHODS

A cross-sectional, observational study was conducted at the largest cancer center in Singapore. Breast cancer patients receiving chemotherapy and not receiving chemotherapy completed the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30), and Beck Anxiety Inventory to assess their perceived cognitive functioning, health-related quality of life, and anxiety, respectively. Multiple regression was conducted to delineate the factors associated with perceived cognitive disturbances.

RESULTS

A total of 85 breast cancer patients receiving chemotherapy and 81 not receiving chemotherapy were recruited. Chemotherapy patients experienced more fatigue (QLQ-C30 fatigue scores: 33.3 vs 22.2 points; p = 0.005) and moderate-to-severe anxiety (21.9% vs 8.6%; p = 0.002) compared to non-chemotherapy patients. Non-chemotherapy patients reported better perceived cognitive functioning than those who received chemotherapy (FACT-Cog scores: 124 vs 110 points, respectively; p < 0.001). Chemotherapy and endocrine therapy were strongly associated with perceived cognitive disturbances (p < 0.001 and 0.021, respectively). The interacting effect between anxiety and fatigue was moderately associated with perceived cognitive disturbances (β = -0.29; p = 0.037).

CONCLUSIONS

Chemotherapy and endocrine treatment were associated with significant cognitive disturbances among Asian breast cancer patients. Psychosocial factors could be used to identify cancer patients who are more susceptible to cognitive disturbances in the clinical setting.

摘要

背景

化疗和心理困扰对癌症患者认知变化的影响存在相互矛盾的证据。

目的

比较接受化疗和未接受化疗的亚洲乳腺癌患者感知认知障碍的严重程度，并确定与感知认知障碍相关的临床特征。

方法

在新加坡最大的癌症中心进行了一项横断面、观察性研究。接受化疗和未接受化疗的乳腺癌患者分别完成了功能评估癌症治疗认知功能（FACT-Cog）、欧洲癌症研究与治疗组织生活质量问卷（QLQ-C30）和贝克焦虑量表，以评估他们的感知认知功能、健康相关生活质量和焦虑情况。进行多元回归以确定与感知认知障碍相关的因素。

结果

共招募了 85 名接受化疗和 81 名未接受化疗的乳腺癌患者。化疗患者经历了更多的疲劳（QLQ-C30 疲劳评分：33.3 分比 22.2 分；p = 0.005）和中重度焦虑（21.9%比 8.6%；p = 0.002），与未接受化疗的患者相比。未接受化疗的患者报告的感知认知功能比接受化疗的患者更好（FACT-Cog 评分：分别为 124 分和 110 分，p < 0.001）。化疗和内分泌治疗与感知认知障碍密切相关（p < 0.001 和 0.021）。焦虑和疲劳之间的相互作用与感知认知障碍中度相关（β = -0.29；p = 0.037）。