Bond Stewart M, Dietrich Mary S, Gilbert Jill, Ely E Wesley, Jackson James C, Murphy Barbara A
Vanderbilt University School of Nursing, Nashville, TN, USA.
Boston College William F. Connell School of Nursing, 378C Maloney Hall, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.
Support Care Cancer. 2016 Oct;24(10):4433-42. doi: 10.1007/s00520-016-3284-1. Epub 2016 May 25.
Cancer and cancer therapy-related neurocognitive changes negatively affect quality of life, yet few studies have examined neurocognitive changes in patients with head and neck cancer. The purpose of this study was to evaluate neurocognitive performance in patients with head and neck cancer at baseline before starting treatment and 3 months after treatment completion to assess treatment-associated changes in performance.
Patients with head and neck cancer who were to receive primary or adjuvant chemoradiation (N = 55) underwent neuropsychological testing before and 3 months posttreatment. Changes in neurocognitive performance were assessed using a practice effect adjusted Reliable Change Index.
At baseline, 38 % of patients exhibited global neurocognitive impairment. Posttreatment, 21.8 % demonstrated declines in neurocognitive performance in at least one domain. Declines in domain-specific performance ranged from 1.8 to 12.7 % with the greatest decline in language, specifically verb retrieval. Domain-specific improvements ranged from 0 to 7.3 %.
Patients had a high prevalence of baseline neurocognitive impairment. While neurocognitive performance posttreatment remained unchanged in the majority, almost 13 % suffered declines in language. Small percentages of patients exhibited improvements in their performance. Long-term effects and risk factors for neurocognitive decline in this population should be studied on a larger scale.
癌症及与癌症治疗相关的神经认知改变会对生活质量产生负面影响，但很少有研究对头颈部癌患者的神经认知改变进行过考察。本研究的目的是评估头颈部癌患者在开始治疗前的基线水平以及治疗完成后3个月时的神经认知表现，以评估与治疗相关的表现变化。
将接受原发或辅助放化疗的头颈部癌患者（N = 55）在治疗前及治疗后3个月进行神经心理学测试。使用经练习效应调整的可靠变化指数评估神经认知表现的变化。
在基线时，38%的患者表现出整体神经认知损害。治疗后，21.8%的患者在至少一个领域的神经认知表现出现下降。特定领域表现的下降幅度为1.8%至12.7%，其中语言方面下降最大，尤其是动词检索。特定领域的改善幅度为0至7.3%。
患者基线神经认知损害的患病率较高。虽然大多数患者治疗后的神经认知表现保持不变，但近13%的患者语言能力下降。小部分患者的表现有所改善。该人群神经认知下降的长期影响和危险因素应进行更大规模的研究。
