Department of Psychology, York University, Toronto, ON, Canada.
Clinical Neuropsychology Service, St. Josephs Healthcare, 100 West 5th Street, Room G191, Hamilton, ON, L8N 3K7, Canada.
Breast Cancer Res Treat. 2017 Nov;166(1):15-28. doi: 10.1007/s10549-017-4376-4. Epub 2017 Jul 13.
Women with breast cancer have reported adverse cognitive effects following chemotherapy. Evidence is mixed on whether executive functioning is particularly impaired in women treated with chemotherapy, in part due to the wide range of tasks used to measure executive processes. We performed a systematic review of the published literature to evaluate whether some subcomponents of executive functioning are more vulnerable to impairment than others among breast cancer survivors who had been treated with chemotherapy.
Studies published as of April 2017 were identified using three electronic databases (MEDLINE, PsycINFO, and Web of Science) and a manual search of relevant reference lists. The methodological quality of included studies was assessed using a checklist of predefined criteria.
Of 1280 identified articles, a total of 41 were included for review. Study findings were categorized into three primary subdomains of executive functioning: inhibition, shifting, and updating. Although there was heterogeneity in the neuropsychological measures used to assess executive functioning, tests could be grouped into the subcomponents they assessed. Inhibition appears relatively spared from the effects of chemotherapy, whereas impairments in shifting and updating are more commonly found following chemotherapy.
Examination of subcomponents of executive functioning is recommended to better characterize the nature of executive dysfunction in women treated with chemotherapy. Future studies should include executive functioning tasks of varying complexity, use of multiple tasks to increase reliability, and alternative indices to capture performance, such as within-person variability.
乳腺癌患者在接受化疗后报告出现认知功能障碍。有证据表明，接受化疗治疗的女性的执行功能是否特别受损存在差异，部分原因是用于测量执行过程的任务范围很广。我们对已发表的文献进行了系统评价，以评估在接受过化疗的乳腺癌幸存者中，执行功能的某些子成分是否比其他成分更容易受损。
截至 2017 年 4 月，使用三个电子数据库（MEDLINE、PsycINFO 和 Web of Science）和手动搜索相关参考文献表，确定了已发表的研究。使用预先确定标准的清单评估纳入研究的方法学质量。
在 1280 篇鉴定文章中，共有 41 篇文章被纳入综述。研究结果分为执行功能的三个主要子领域：抑制、转换和更新。尽管用于评估执行功能的神经心理学测量方法存在异质性，但可以将测试归入评估的子成分。抑制似乎相对不受化疗影响，而转换和更新受损在化疗后更常见。
建议检查执行功能的子成分，以更好地描述接受化疗的女性执行功能障碍的性质。未来的研究应包括不同复杂程度的执行功能任务，使用多种任务以提高可靠性，并使用替代指标来捕捉表现，如个体内变异性。
