Hess Lisa M, Huang Helen Q, Hanlon Alexandra L, Robinson William R, Johnson Rhonda, Chambers Setsuko K, Mannel Robert S, Puls Larry, Davidson Susan A, Method Michael, Lele Shashikant, Havrilesky Laura, Nelson Tina, Alberts David S
Indiana University School of Medicine, Indianapolis, IN 46202, United States.
NRG Oncology/Gynecologic Oncology Group Statistics and Data Center, Buffalo, NY, United States.
Gynecol Oncol. 2015 Dec;139(3):541-5. doi: 10.1016/j.ygyno.2015.10.003. Epub 2015 Oct 9.
Changes in cognitive function have been identified in and reported by many cancer survivors. These changes have the potential to impact patient quality of life and functional ability. This prospective longitudinal study was designed to quantify the incidence of change in cognitive function in newly diagnosed ovarian cancer patients throughout and following primary chemotherapy.
Eligible patients had newly diagnosed, untreated ovarian cancer and had planned to receive chemotherapy. Web-based and patient reported cognitive assessments and quality of life questionnaires were conducted prior to chemotherapy, prior to cycle four, after cycle six, and six months after completion of primary therapy.
Two-hundred-thirty-one evaluable patients entered this study between May 2010 and October 2011. At the cycle 4 time point, 25.2% (55/218) of patients exhibited cognitive impairment in at least one domain. At the post-cycle 6 and 6-month follow up time points, 21.1% (44/208) and 17.8% (30/169) of patients, respectively, demonstrated impairment in at least one domain of cognitive function. There were statistically significant, but clinically small, improvements in processing speed (p<0.001) and attention (p<0.001) but not in motor response time (p=0.066), from baseline through the six-month follow up time period.
This was a large, prospective study designed to measure cognitive function in ovarian cancer. A subset of patients had evidence of cognitive decline from baseline during chemotherapy treatment in this study as measured by the web-based assessment; however, changes were generally limited to no more than one domain.
许多癌症幸存者体内已发现并报告了认知功能的变化。这些变化可能会影响患者的生活质量和功能能力。本前瞻性纵向研究旨在量化新诊断的卵巢癌患者在初次化疗期间及之后认知功能变化的发生率。
符合条件的患者为新诊断的、未经治疗的卵巢癌患者,且计划接受化疗。在化疗前、第四个周期前、第六个周期后以及初次治疗完成后六个月,通过网络进行认知评估和患者报告的生活质量问卷调查。
2010年5月至2011年10月期间,231名可评估患者进入本研究。在第4周期时间点,25.2%(55/218)的患者在至少一个领域表现出认知障碍。在第6周期后和6个月随访时间点,分别有21.1%(44/208)和17.8%(30/169)的患者在至少一个认知功能领域表现出障碍。从基线到六个月随访期,处理速度(p<0.001)和注意力(p<0.001)有统计学意义但临床意义较小的改善,而运动反应时间无改善(p=0.066)。
这是一项旨在测量卵巢癌患者认知功能的大型前瞻性研究。在本研究中,通过网络评估发现,一部分患者在化疗期间出现了从基线开始的认知功能下降;然而,变化通常仅限于不超过一个领域。