Collins Barbara, Mackenzie Joyce, Tasca Giorgio A, Scherling Carole, Smith Andra
1 Psychology Department, The Ottawa Hospital, Ottawa, Ontario, Canada.
3 Memory and Aging Centre, University of California, San Francisco (UCSF), San Francisco, California.
J Int Neuropsychol Soc. 2014 Apr;20(4):370-9. doi: 10.1017/S1355617713001215. Epub 2013 Nov 15.
Numerous studies have shown that there are acute cognitive side-effects of chemotherapy for breast cancer. Presumably, patients are more concerned about chronic treatment effects. This report from a prospective longitudinal study compares cognitive functioning in 56 breast cancer patients 1 year after chemotherapy to that of 56 healthy individuals. Neuropsychological test scores were combined into verbal memory, visual memory, working memory, and processing speed scores, as well as an overall summary score, and analyzed using multi-level growth modeling. Frequency of cognitive decline was assessed using regression-based change scores. There was significant rebound in the overall summary score from end of treatment to 1-year follow-up as well as a substantial reduction in the frequency of cognitive decline. However, more than one-third of the breast cancer patients who showed cognitive decline immediately following completion of chemotherapy showed persistent cognitive decline 1 year later. Furthermore, recovery was not seen in all cognitive domains. In fact, the rebound was significant only for working memory. Longer multi-site studies are recommended to explore the risk factors for and the permanence of these longer-term cognitive effects.
众多研究表明，乳腺癌化疗存在急性认知副作用。据推测，患者更关注慢性治疗效果。这项前瞻性纵向研究报告比较了56名乳腺癌患者化疗1年后与56名健康个体的认知功能。神经心理学测试分数被合并为言语记忆、视觉记忆、工作记忆、处理速度分数以及一个总体综合分数，并使用多层次生长模型进行分析。认知衰退频率通过基于回归的变化分数进行评估。从治疗结束到1年随访，总体综合分数有显著反弹，认知衰退频率也大幅降低。然而，超过三分之一在化疗刚结束时出现认知衰退的乳腺癌患者在1年后仍存在持续性认知衰退。此外，并非所有认知领域都出现了恢复。事实上，仅工作记忆方面的反弹较为显著。建议开展更长时间的多中心研究，以探究这些长期认知效应的风险因素及持久性。
