Bai Lu, Yu Enyan
Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.
Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Beijing, China.
Ann Transl Med. 2021 Jan;9(1):72. doi: 10.21037/atm-20-6443.
Cancer-related cognitive impairment (CRCI) refers to a series of cognitive impairment symptoms associated with alternations in brain structure and function, caused by a non-central nervous system malignant tumor and its related treatment. CRCI may present as memory loss, impaired concentration, difficulty in multitasking and word retrieval, and reduced comprehension speed. CRCI has become one of the prevalent factors that compromise the quality of life for cancer survivors. Different treatments, including surgery, chemotherapy, radiotherapy, endocrine therapy, and targeted drugs, may contribute to CRCI. Meanwhile, patients' factors, including emotional challenges and genetic makeup, also contribute to the development of CRCI. The condition can be treated with using stimulants methylphenidate and modafinil, metabolites of nicotine: cotinine, antidepressants of fluoxetine and fluvoxamine, dementia drug of donepezil, and antioxidants ZnSO4, n-acetyl cysteine, propofol, and Chinese herbal of silver leaf medicine. Psychotherapies, including meditation and relaxation, cognitive rehabilitation training, along with physical therapies, including aerobic exercise, resistance training, balance training, yoga, qigong, tai chi electroencephalogram biofeedback, and acupuncture, are also beneficial in alleviating cancer-related cognitive impairment symptoms. In recent years, researchers have focused on factors related to the condition and on the available interventions. However, most research was conducted independently, and no review has yet summarized the latest findings. This review details and discusses the status of related factors and potential treatments for CRCI. We also supply specific recommendations to facilitate future research and integration in this field.
癌症相关认知障碍(CRCI)是指由非中枢神经系统恶性肿瘤及其相关治疗引起的、与脑结构和功能改变相关的一系列认知障碍症状。CRCI可能表现为记忆力减退、注意力不集中、多任务处理和单词检索困难以及理解速度下降。CRCI已成为影响癌症幸存者生活质量的常见因素之一。包括手术、化疗、放疗、内分泌治疗和靶向药物在内的不同治疗方法都可能导致CRCI。同时,患者自身因素,包括情绪挑战和基因构成,也会促使CRCI的发生。可以使用兴奋剂哌甲酯和莫达非尼、尼古丁的代谢产物可替宁、抗抑郁药氟西汀和氟伏沙明、痴呆症药物多奈哌齐以及抗氧化剂硫酸锌、N-乙酰半胱氨酸、丙泊酚和银杏叶中药来治疗这种疾病。心理疗法,包括冥想和放松、认知康复训练,以及物理疗法,包括有氧运动、阻力训练、平衡训练、瑜伽、气功、太极拳脑电图生物反馈和针灸,也有助于缓解癌症相关认知障碍症状。近年来,研究人员一直关注与该疾病相关的因素以及可用的干预措施。然而,大多数研究都是独立进行的,尚未有综述总结最新研究结果。本综述详细介绍并讨论了CRCI相关因素和潜在治疗方法的现状。我们还提供了具体建议,以促进该领域未来的研究和整合。