Yonsei University College of Medicine, Seoul, Korea.
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
Cancer Res Treat. 2021 Oct;53(4):1134-1147. doi: 10.4143/crt.2020.1191. Epub 2021 Mar 17.
Chemotherapy-related cognitive impairment (CRCI) is a controversial concept not much explored on colorectal cancer patients.
We identified 11 prospective studies: eight studies on 696 colorectal cancer patients who received chemotherapy and three studies on 346 rectal cancer patients who received neoadjuvant chemoradiotherapy. Standardized mean differences (SMDs) of neuropsychological test results and the cognitive quality-of-life scale were calculated using random effect models. A meta-regression was conducted to investigate the association between mean study population age and effect sizes.
The association between chemotherapy and cognitive impairment was not clear in colorectal cancer patients (SMD, 0.003; 95% confidence interval, ‒0.080 to 0.086). However, a meta-regression showed that older patients are more vulnerable to CRCI than younger patients (β=‒0.016, p < 0.001).
Chemotherapy has an overall positive negligible effect size on the cognitive function of colorectal patients. Age is a significant moderator of CRCI.
化疗相关性认知障碍（CRCI）是一个备受争议的概念，在结直肠癌患者中尚未得到充分探讨。
我们确定了 11 项前瞻性研究：8 项研究纳入了 696 例接受化疗的结直肠癌患者，3 项研究纳入了 346 例接受新辅助放化疗的直肠癌患者。采用随机效应模型计算神经心理学测试结果和认知生活质量量表的标准化均数差值（SMD）。进行了荟萃回归分析，以探讨研究人群平均年龄与效应大小之间的关系。
在结直肠癌患者中，化疗与认知障碍之间的关联并不明确（SMD，0.003；95%置信区间，-0.080 至 0.086）。然而，荟萃回归分析显示，年龄较大的患者比年龄较小的患者更容易发生 CRCI（β=-0.016，p<0.001）。
化疗对结直肠癌患者的认知功能总体上有轻微的积极影响。年龄是 CRCI 的一个重要调节因素。
