鼻咽癌患者诱导化疗后认知功能障碍。

Cognitive dysfunction in patients with nasopharyngeal carcinoma after induction chemotherapy.

机构信息

Department of Radiation Oncology, the First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen 361003, People's Republic of China.

出版信息

Oral Oncol. 2020 Dec;111:104921. doi: 10.1016/j.oraloncology.2020.104921. Epub 2020 Aug 4.

DOI:10.1016/j.oraloncology.2020.104921

PMID:32763779

Abstract

OBJECTIVE

This prospective study aimed to assess the incidence, details of the change of cognitive dysfunction, and predictive factors of cognitive function impairment associated with induction chemotherapy (IC) in nasopharyngeal carcinoma (NPC) patients.

METHOD

We prospectively included NPC patients who treated with IC from December 2018 to January 2020. Montreal cognitive assessment (MoCA) was used to measure cognitive function, and score less than 26 was defined as cognitive dysfunction. Multivariate logistic regression analysis was applied to assess the independent predictors associated with cognitive function impairment.

RESULTS

A total of 76 patients were recruited, 10 patients were excluded due to refusal or unable to finish the questionnaire, and 66 patients were analyzed in this study. The median age of the patients was 48.5 years (range, 24-69 years). There was 89.4% of patients received ≥3 circles of IC. For the entire group, 27.3% had cognitive dysfunction, of which attention, language, short-term memory, and orientation showed significant downward trends, while visuospatial/executive function, naming, and abstraction demonstrated no prominent decrease. In patients having cognitive function impairment, 77.8% of them occurred after the first circle of IC. Gender (P = 0.039) and education (P = 0.03) were significant predictors for cognitive dysfunction. Female patients (female vs. male: 50% vs. 20%) and patients with lower educational levels (lower vs. higher: 37.8% vs. 11.8%) were more likely to suffer cognitive dysfunction. In addition, age (P = 0.572) and chemotherapy circles (P = 0.68) had no association with cognitive dysfunction.

CONCLUSION

Approximately 25% of NPC patients suffered cognitive dysfunction after IC, especially in female patients and patients with lower educational levels.

摘要

目的

本前瞻性研究旨在评估诱导化疗（IC）相关的鼻咽癌（NPC）患者认知功能障碍的发生率、变化细节和预测因素。

方法

我们前瞻性纳入了 2018 年 12 月至 2020 年 1 月接受 IC 治疗的 NPC 患者。采用蒙特利尔认知评估量表（MoCA）评估认知功能，得分<26 定义为认知功能障碍。采用多变量逻辑回归分析评估与认知功能障碍相关的独立预测因素。

结果

共纳入 76 例患者，10 例因拒绝或无法完成问卷而被排除，最终 66 例患者纳入本研究。患者的中位年龄为 48.5 岁（范围，24-69 岁）。89.4%的患者接受了≥3 个周期的 IC。对于整个组，27.3%的患者有认知功能障碍，其中注意力、语言、短期记忆和定向力呈显著下降趋势，而视空间/执行功能、命名和抽象能力则没有明显下降。在有认知功能障碍的患者中，77.8%的患者在第一个 IC 周期后发生。性别（P=0.039）和教育程度（P=0.03）是认知功能障碍的显著预测因素。女性患者（女性 vs. 男性：50% vs. 20%）和教育程度较低的患者（较低 vs. 较高：37.8% vs. 11.8%）更容易发生认知功能障碍。此外，年龄（P=0.572）和化疗周期（P=0.68）与认知功能障碍无关。