Lycke Michelle, Pottel Lies, Pottel Hans, Ketelaars Lore, Stellamans Karin, Van Eygen Koen, Vergauwe Philippe, Werbrouck Patrick, Goethals Laurence, Schofield Patricia, Boterberg Tom, Debruyne Philip R
Division of Medical Oncology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium.
Department of Public Health and Primary Care @ Kulak, Catholic University Leuven Kulak, Kortrijk, Belgium.
Psychooncology. 2017 May;26(5):632-639. doi: 10.1002/pon.4200. Epub 2016 Aug 1.
Recent research in the field of cancer-related cognitive impairments (CRCI) has shown CRCI presentation prior to treatment initiation. Some have attributed these problems to worry and fatigue, whereas others have suggested an influence of age, IQ, and other psychosocial and medical factors.
Patients (≥18 years) with a histologically confirmed diagnosis of a solid cancer or hematological malignancy, scheduled for a curative treatment, were evaluated with a baseline neuropsychological assessment including Patient-Reported Outcome Measures (PROMs). PROMs entailed distress, anxiety and depression, fatigue, and cognitive complaints. The neuropsychological assessment comprised several cognitive domains such as premorbid IQ, attention, processing speed, flexibility, verbal and visual episodic memory, and verbal fluency.
Cross-sectional data of 125 patients were collected. Patients had a mean age of 60.9 years (range: 30.0-85.0) and comprised primarily females (65.6%). Patients presented with cancer of following sites: breast (44.0%), digestive (28.8%), urological (11.2%), gynecologic (8.0%), hematologic malignancy (4.8%), and lung (3.2%). Patients presented with a premorbid IQ of 105.3 (range: 79.0-124.0). In 29.6% of patients, a CRCI was detected. Binary logistic regression analyses showed that a lower premorbid IQ (β = -.084, P < .01) and a higher level of fatigue (β = -.054, P < .05) predicted baseline CRCI. Premorbid IQ also predicted performance on individual cognitive domains. Some domains were also influenced by age, gender, having a breast cancer diagnosis, and an active treatment for hypertension.
Premorbid IQ and fatigue are important predictors of baseline CRCI. Therefore, we advise researchers to implement a short IQ test when conducting clinical trials on CRCI.
癌症相关认知障碍（CRCI）领域的最新研究表明，在开始治疗之前就已出现CRCI症状。一些人将这些问题归因于担忧和疲劳，而另一些人则认为年龄、智商以及其他社会心理和医学因素有影响。
对组织学确诊为实体癌或血液系统恶性肿瘤且计划进行根治性治疗的患者（≥18岁）进行基线神经心理学评估，包括患者报告结局量表（PROMs）。PROMs包括痛苦、焦虑和抑郁、疲劳以及认知主诉。神经心理学评估涵盖多个认知领域，如病前智商、注意力、处理速度、灵活性、言语和视觉情景记忆以及言语流畅性。
收集了125例患者的横断面数据。患者的平均年龄为60.9岁（范围：30.0 - 85.0岁），主要为女性（65.6%）。患者所患癌症部位如下：乳腺（44.0%）、消化系统（28.8%）、泌尿系统（11.2%）、妇科（8.0%）、血液系统恶性肿瘤（4.8%）和肺部（3.2%）。患者的病前智商为105.3（范围：79.0 - 124.0）。在29.6%的患者中检测到CRCI。二元逻辑回归分析表明，较低的病前智商（β = -0.084，P < 0.01）和较高水平的疲劳（β = -0.054，P < 0.05）可预测基线CRCI。病前智商还可预测各个认知领域的表现。一些领域也受年龄、性别、乳腺癌诊断以及高血压的积极治疗影响。
病前智商和疲劳是基线CRCI的重要预测因素。因此，我们建议研究人员在进行CRCI临床试验时实施简短的智商测试。
