College of Nursing, The Catholic University of Korea, Seoul, South Korea.
College of Nursing, Seoul National University, Seoul, South Korea.
Psychooncology. 2020 Apr;29(4):617-631. doi: 10.1002/pon.5339. Epub 2020 Feb 3.
This systematic review of longitudinal studies, assessing subjective cognitive impairment (SCI) reported by adult cancer patients, aimed to summarize evidence on the impact of chemotherapy on SCI, identify moderators of SCI, and evaluate methodological issues.
Data accrued from Pubmed, EMBASE, CINAHL, PsychInfo, and the Cochrane library. Inclusion criteria were original studies, an exclusively adult sample, valid and reliable subjective cognitive measures, and at least one baseline data point prior to and another after the initiation of chemotherapy. Data were collected on the sample composition, data-collection time points, outcome measures, statistical analysis, and major findings (ie, longitudinal changes in prevalence, severity, and associated factors).
Forty articles published between 2004 and 2019 were retained: 21 examined chemotherapy-treated patients only, and 19 employed control groups. Findings were mixed, with slightly more studies supporting the impact of chemotherapy on SCI. SCI tended to be more prevalent and severe after initiating chemotherapy, compared with patients' own baseline and controls not treated with chemotherapy. Impact appeared to be acute and more likely limited to subsamples. Most studies examining non-breast-cancer samples reported the lack or limited impact of chemotherapy on SCI. The most consistent moderators were depression and fatigue. Methodological issues regarding sampling design, measurement, and statistical analysis were discussed.
More rigorously designed longitudinal studies would clarify direct and indirect effects of chemotherapy on SCI.
本系统综述评估了成人癌症患者主观认知障碍（SCI）的纵向研究，旨在总结化疗对 SCI 影响的证据，确定 SCI 的调节因素，并评估方法学问题。
从 Pubmed、EMBASE、CINAHL、PsychInfo 和 Cochrane 图书馆中获取数据。纳入标准为原始研究、纯成人样本、有效的和可靠的主观认知测量以及至少有一个在开始化疗之前和之后的基线数据点。收集了样本组成、数据收集时间点、结果测量、统计分析和主要发现（即 SCI 发生率、严重程度和相关因素的纵向变化）的数据。
保留了 2004 年至 2019 年发表的 40 篇文章：21 篇仅检查化疗治疗患者，19 篇采用对照组。研究结果喜忧参半，更多的研究支持化疗对 SCI 的影响。与患者自身的基线相比，开始化疗后 SCI 更普遍且更严重，与未接受化疗的对照组相比也是如此。影响似乎是急性的，更可能局限于亚组。大多数检查非乳腺癌样本的研究报告称，化疗对 SCI 的影响有限或缺乏。最一致的调节因素是抑郁和疲劳。讨论了关于抽样设计、测量和统计分析的方法学问题。
更严格设计的纵向研究将阐明化疗对 SCI 的直接和间接影响。
