Facultad de Psicología, Universidad Complutense de Madrid, Campus de Somosaguas, 28223, Madrid, Spain,
Support Care Cancer. 2014 Jul;22(7):1815-23. doi: 10.1007/s00520-014-2147-x. Epub 2014 Feb 18.
Chemotherapy can induce cognitive impairment in cancer patients. The main goal of this longitudinal study was to determine the incidence, characteristics, and duration of cognitive dysfunction in patients treated with adjuvant chemotherapy for colon cancer.
We assessed cognitive function, quality of life, anxiety and depression, fatigue, and hemoglobin levels in colon cancer patients at three assessment points: pre-chemotherapy (n=81), post-chemotherapy (n=73), and after 6-month follow-up (n=54). All patients were treated with oxaliplatin plus 5-fluorouracil/leucovorin (FOLFOX4) for 6 months.
Thirty patients (37%) had cognitive impairment in the pre-chemotherapy evaluation, mainly in processing speed and psychomotor executive function (Trail Making Test A and B). At the end of treatment, the main domain affected was the verbal memory, with an acute decline detected in 56% of patients. Fifty-four percent of the patients improved their dysfunction after 6 months of follow-up, whereas 18 (33%) of them showed worsening in at least one test. Cognitive impairment was most common in older patients and in those with less years of education. Quality of life, anxiety, depression, fatigue, and hemoglobin did not influence the results of the cognitive tests.
Adjuvant FOLFOX4 in patients with colon cancer can have a negative effect on verbal memory. This deterioration is usually mild and transient.
化疗会导致癌症患者认知功能受损。本纵向研究的主要目的是确定接受辅助化疗治疗结肠癌患者认知功能障碍的发生率、特征和持续时间。
我们在三个评估点评估了结肠癌患者的认知功能、生活质量、焦虑和抑郁、疲劳和血红蛋白水平：化疗前（n=81）、化疗后（n=73）和 6 个月随访后（n=54）。所有患者均接受奥沙利铂联合 5-氟尿嘧啶/亚叶酸钙（FOLFOX4）治疗 6 个月。
30 名患者（37%）在化疗前评估中存在认知障碍，主要表现为处理速度和精神运动执行功能（连线测试 A 和 B）受损。治疗结束时，受影响的主要领域是语言记忆，56%的患者出现急性下降。54%的患者在随访 6 个月后改善了他们的功能障碍，而 18 名患者（33%）在至少一项测试中出现恶化。认知障碍在老年患者和受教育年限较少的患者中更为常见。生活质量、焦虑、抑郁、疲劳和血红蛋白水平均未影响认知测试结果。
结肠癌患者接受辅助 FOLFOX4 化疗可能对语言记忆产生负面影响。这种恶化通常是轻微和短暂的。
