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认知障碍与化疗:简要概述

Cognitive impairment and chemotherapy: a brief overview.

作者信息

Vitali Milena, Ripamonti Carla Ida, Roila Fausto, Proto Claudia, Signorelli Diego, Imbimbo Martina, Corrao Giulia, Brissa Angela, Rosaria Gallucci, de Braud Filippo, Garassino Marina Chiara, Lo Russo Giuseppe

机构信息

Medical Oncology Department, Fondazione IRCCS Istituto Nazionale di Tumori, Milan, Italy.

Supportive Care in Cancer Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.

出版信息

Crit Rev Oncol Hematol. 2017 Oct;118:7-14. doi: 10.1016/j.critrevonc.2017.08.001. Epub 2017 Aug 14.

Abstract

Patients with cancer are experiencing long-term survival following chemotherapy, but the treatment may also be associated with short and long-term toxicity, including the possibility of cognitive dysfunction. A literature overview indicated a significant association between chemotherapy and cognitive impairment but prospective longitudinal research is warranted to examine the degree and persisting nature of this decline. Although chemotherapeutic agents are unlikely to cross the blood-brain barrier, it has been alleged that the occurrence of neurotoxicity is linked to the pro-inflammatory cytokine pathways. Moreover in most cases many other factors could play an ancillary and concomitant role. The contribution of hormone therapy as well as emotional, social, behavioural and genetic factors should always be considered. Especially physical activity and cognitive training appear promising in the management of cognitive impairment but additional studies are required to establish their efficacy.

摘要

癌症患者在化疗后正经历长期生存,但该治疗也可能与短期和长期毒性相关,包括认知功能障碍的可能性。文献综述表明化疗与认知障碍之间存在显著关联,但有必要进行前瞻性纵向研究以检查这种衰退的程度和持续性质。尽管化疗药物不太可能穿过血脑屏障,但据称神经毒性的发生与促炎细胞因子途径有关。此外,在大多数情况下,许多其他因素可能起辅助和伴随作用。应始终考虑激素治疗以及情绪、社会、行为和遗传因素的作用。特别是体育活动和认知训练在认知障碍的管理中似乎很有前景,但需要更多研究来确定它们的疗效。

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