Henneghan Ashley
University of Texas at Austin, 1710 Red River, Austin, TX, 78701, USA.
Support Care Cancer. 2016 Jan;24(1):481-497. doi: 10.1007/s00520-015-2927-y. Epub 2015 Sep 29.
It is unknown why some breast cancer survivors experience cancer-related cognitive impairments (CRCI) after cancer treatment, and modifiable risk factors for CRCI remain to be explicated. This mixed-method systematic review synthesizes quantitative and qualitative evidence for relationships between modifiable factors and CRCI in breast cancer survivors who receive chemotherapy as part of their treatment.
Keyword Searches of PubMed/Medline, PsychINFO, and CINAHL were performed for January 2005 through June 2015. Studies that provided data on associations between modifiable biological, behavioral, environmental, and psychosocial factors and cognition were included.
Twenty-two quantitative studies and five qualitative studies were identified after applying inclusion and exclusion criteria yielding evidence for significant relationships among modifiable biological (inflammatory cytokines), behavioral (sleep quality, physical activity), and psychosocial (stress, distress, affect) factors and CRCI.
Many women unfortunately experience CRCI after breast cancer chemotherapy, with limited treatment options available to improve cognitive function. This review synthesizes current evidence to support the associations between modifiable factors and CRCI and can inform research to evaluate these factors prospectively. The clinical implications of these findings suggest that lifestyle factors such as physical activity, stress management, and sleep quality may be appropriate targets for behavioral interventions to improve cognitive function following breast cancer chemotherapy; however, further research is necessary.
尚不清楚为何一些乳腺癌幸存者在癌症治疗后会出现癌症相关认知障碍（CRCI），且CRCI的可改变风险因素仍有待阐明。本混合方法系统评价综合了定量和定性证据，以探究在接受化疗作为治疗一部分的乳腺癌幸存者中，可改变因素与CRCI之间的关系。
对2005年1月至2015年6月期间的PubMed/Medline、PsychINFO和CINAHL进行关键词检索。纳入提供了可改变的生物学、行为、环境和心理社会因素与认知之间关联数据的研究。
在应用纳入和排除标准后，确定了22项定量研究和5项定性研究，这些研究为可改变的生物学（炎性细胞因子）、行为（睡眠质量、身体活动）和心理社会（压力、痛苦、情感）因素与CRCI之间的显著关系提供了证据。
不幸的是，许多女性在乳腺癌化疗后会出现CRCI，而改善认知功能的治疗选择有限。本综述综合了当前证据，以支持可改变因素与CRCI之间的关联，并可为前瞻性评估这些因素的研究提供参考。这些发现的临床意义表明，身体活动、压力管理和睡眠质量等生活方式因素可能是乳腺癌化疗后改善认知功能的行为干预的合适目标；然而，仍需进一步研究。
