Peukert Xenia, Steindorf Karen, Schagen Sanne B, Runz Adrian, Meyer Patric, Zimmer Philipp
Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
SRH Hochschule Heidelberg, Heidelberg, Germany.
Front Oncol. 2020 Feb 21;10:147. doi: 10.3389/fonc.2020.00147. eCollection 2020.
Although improvements in medical treatment lead to a steadily rising survival rate of breast cancer patients (BCP), it is associated with a decrease in cognitive and affective function. The hippocampus, a brain region with a high influence on both cognitive and affective function, is increasingly becoming the focus of current research because of its high vulnerability to adverse direct (chemotherapeutic agents, endocrine therapeutic agents, and radiation) or indirect (stress and other psycho-social factors) treatment-related effects. This systematic review analyses current data from literature combining hippocampus-related brain changes due to breast cancer treatment with associated cancer-related cognitive and affective impairments (CRCI/CRAI). The seven studies that met the inclusion criteria consisted of six cross-sectional studies and one longitudinal study. The study results indicate hippocampal differences across all types of treatment. Those differences include volume loss, deformation, and changes in functional connectivity. They are associated with CRCI, revealing executive function as well as working memory, episodic memory, and prospective memory as the most affected domains. Although an interaction between hippocampus-related brain changes, CRCI, and CRAI can be hypothesized, CRAI are less reflected in current research. More research including longitudinal assessments with better overall methodology is needed to fully understand the interaction between hippocampal alterations and both CRCI and CRAI due to breast cancer treatment.
尽管医疗水平的提高使乳腺癌患者（BCP）的生存率稳步上升，但这与认知和情感功能的下降有关。海马体是一个对认知和情感功能有高度影响的脑区，由于其极易受到不良直接（化疗药物、内分泌治疗药物和辐射）或间接（压力和其他心理社会因素）治疗相关影响，正日益成为当前研究的焦点。本系统综述分析了文献中的现有数据，这些数据将乳腺癌治疗导致的与海马体相关的大脑变化与相关的癌症相关认知和情感障碍（CRCI/CRAI）结合起来。符合纳入标准的七项研究包括六项横断面研究和一项纵向研究。研究结果表明，所有类型的治疗都会导致海马体出现差异。这些差异包括体积减小、变形以及功能连接的变化。它们与CRCI相关，显示执行功能以及工作记忆、情景记忆和前瞻性记忆是受影响最大的领域。尽管可以假设与海马体相关的大脑变化、CRCI和CRAI之间存在相互作用，但目前的研究较少反映CRAI。需要更多包括采用更好总体方法的纵向评估的研究，以充分了解乳腺癌治疗导致的海马体改变与CRCI和CRAI之间的相互作用。
