Pearre Diana C, Bota Daniela A
Department of Obstetrics and Gynecology, University of California, Irvine School of Medicine, Irvine, CA, USA.
Department of Neurology, Department of Neurological Surgery, and Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA, USA.
Expert Rev Qual Life Cancer Care. 2018;3(1):19-26. doi: 10.1080/23809000.2018.1443811. Epub 2018 Feb 26.
chemotherapy-related cognitive dysfunction (CRCD) is a growing problem due to rising cancer rates and increasing numbers of cancer survivors. upwards of 70% of ovarian cancer patients report cognitive-changes following treatment for their cancer.
the underlying mechanisms of CRCD are a subject of active research and debate. the initial insult may start with the diagnosis of cancer itself, both in the number of peripheral cytokines it produces but also in the psychological changes caused by stress and anxiety associated with the diagnosis. chemotherapy, in its ability to alter dna in the replication cycle, has been shown to damage neurons and their stem cell precursors.
based on proposed mechanisms and advancements in other neuropsychological diseases, various pharmacologic and behavioral interventions have been demonstrated to show improvements in patient's quality of life and in their perceived cognitive abilities and memory. further research is necessary to be able to determine when and how these cognitive changes occur, and if their multiple potential biological underpinnings can synergize toward deleterious cognitive effects. future therapies will include prevention strategies to avert CRCD's effects on patients.
由于癌症发病率上升以及癌症幸存者数量增加,化疗相关认知功能障碍(CRCD)正成为一个日益严重的问题。超过70%的卵巢癌患者在癌症治疗后报告有认知变化。
CRCD的潜在机制是一个正在积极研究和辩论的主题。最初的损伤可能始于癌症本身的诊断,这不仅在于其产生的外周细胞因子数量,还在于与诊断相关的压力和焦虑所引起的心理变化。化疗改变复制周期中DNA的能力已被证明会损害神经元及其干细胞前体。
基于其他神经心理疾病的提出机制和进展,各种药物和行为干预已被证明可改善患者的生活质量以及他们感知到的认知能力和记忆力。有必要进行进一步研究,以确定这些认知变化何时以及如何发生,以及它们的多种潜在生物学基础是否会协同产生有害的认知影响。未来的治疗将包括预防策略,以避免CRCD对患者的影响。