De Rosa Nicoletta, Della Corte Luigi, Giannattasio Alessia, Giampaolino Pierluigi, Di Carlo Costantino, Bifulco Giuseppe
Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples, Via Sergio Pansini n° 5, 80131, Naples, Italy.
Department of Public Health, University of Naples, Federico II, Naples, Italy.
Arch Gynecol Obstet. 2021 Jun;303(6):1581-1588. doi: 10.1007/s00404-020-05896-6. Epub 2021 Jan 6.
Cancer-related cognitive impairment (CRCI) has been reported in non-central nervous system neoplasms survivors. The purpose of this study was to evaluate the perception of cognitive decrement in patients undergoing surgical and / or medical therapy for gynecological cancers.
All women diagnosed with primary gynecological cancer and undergoing active medical treatment have been enrolled in a prospective study. Before starting treatment (T1) and 6 months after the end of treatment (T2), patients were interviewed to evaluate the effects of cancer treatment on perceived cognitive function (using FACT-Cog -version 3), on depression (using Beck Depression Inventory-II test) and on quality of life (using EORTC-QLQC-30). Age, education level, marital status, lifestyle, menopausal state at diagnosis, cancer type, cancer FIGO stage, treatment modality was also recorded. The differences between baseline and post-treatment results have been evaluated with Student's t test. The results have been stratified by the menopausal state at diagnosis, type of tumor (endometrial, cervical, ovarian, vulvar) disease stage and type of treatment (chemotherapy or radiotherapy).
Seventy-three patients were included. A significant reduction in perceived cognitive impairments was demonstrated at T2 (CogPCI: 61.35 ± 13.83 vs 55.05 ± 16.56; p < 0.05). On the contrary, a significant improvement was shown in depression state (BDII: 21.14 ± 11.23 vs 12.82 ± 12.33, p < 0.005). The menopausal state at surgery, tumor site, stage and treatment modality seem to influence the variables analyzed.
CRCI is a true risk also in gynecological cancer survivors. The cognitive impairment does not seem to be dependent on depression state after treatment or to a menopausal condition. Assessing cognitive decline in cancer survivorship is essential for ensuring the optimum quality of life and functioning.
已有报道称非中枢神经系统肿瘤幸存者存在癌症相关认知障碍（CRCI）。本研究的目的是评估接受妇科癌症手术和/或药物治疗的患者对认知功能减退的感知情况。
所有被诊断为原发性妇科癌症并正在接受积极治疗的女性均纳入一项前瞻性研究。在开始治疗前（T1）和治疗结束后6个月（T2），对患者进行访谈，以评估癌症治疗对感知认知功能（使用FACT-Cog第3版）、抑郁（使用贝克抑郁量表-II测试）和生活质量（使用欧洲癌症研究与治疗组织生活质量核心问卷-30）的影响。还记录了年龄、教育水平、婚姻状况、生活方式、诊断时的绝经状态、癌症类型、癌症国际妇产科联盟（FIGO）分期、治疗方式。用学生t检验评估基线和治疗后结果之间的差异。结果按诊断时的绝经状态、肿瘤类型（子宫内膜癌、宫颈癌、卵巢癌、外阴癌）、疾病分期和治疗类型（化疗或放疗）进行分层。
纳入73例患者。在T2时，感知认知障碍有显著降低（认知功能损害感知量表：61.35±13.83对55.05±16.56；p<0.05）。相反，抑郁状态有显著改善（贝克抑郁量表-II：21.14±11.23对12.82±12.33，p<0.005）。手术时的绝经状态、肿瘤部位、分期和治疗方式似乎会影响所分析的变量。
CRCI在妇科癌症幸存者中也是一个真正的风险。认知障碍似乎不依赖于治疗后的抑郁状态或绝经状态。评估癌症幸存者的认知衰退对于确保最佳生活质量和功能至关重要。
