非中枢神经系统癌症患者的神经认知功能障碍及其预测因素：南非一家学术医院神经肿瘤学研究的基本原理与方法
Neurocognitive Dysfunction and predictors in non-CNS cancer patients: Rationale and methods for the neuro-oncology research at a South African academic hospital.
作者信息
Lentoor Antonio G, Motsamai Tiro Bright
机构信息
Department of Clinical Psychology, School of Medicine, Sefako Makgatho Health Sciences University, Molotlegi St, Ga-Rankuwa, Pretoria, South Africa.
出版信息
Heliyon. 2023 Nov 28;10(1):e23007. doi: 10.1016/j.heliyon.2023.e23007. eCollection 2024 Jan 15.
BACKGROUND
The focus on central nervous system (CNS) malignancies has overshadowed scant but substantial research that suggests non-central nervous cancer patients experience cancer-related cognitive impairment (CRCI), which affects higher-order brain function and influences their quality of life. Despite such evidence of the occurrence of CRCI among non-CNS cancer patients, the factors associated with the CRCIs remain a highly debated issue with discrepancies noted. Whether non-CNS cancer itself can affect the brain independent of cancer treatment is an important question to unpack. This necessitates further research, particularly in the sub-Saharan region where the evidence is limited.
METHODS
This study aims to assess the effect of chemotherapy-associated cognitive and affective changes in non-CNS cancer patients. A non-experimental, time-series, correlational design will be used, in which a battery of computerized neuropsychological tests will be administered, including the e-MoCA, the CNS Vital Signs, the Patient Health Questionnaire-4, the Center for Epidemiologic Studies Depression Scale, the Hamilton Anxiety Rating Scale, the Functional Assessment of Cancer Therapy-Fatigue, and the Semi-structured Interview Schedule. Descriptive and inferential statistical analysis will be conducted, as well as NVivo thematic analysis of the qualitative data. The scope of the neurocognitive issues and risk factors that may be present in cancer patients and survivors in a developing environment could be determined by this study.
IMPLICATIONS
The study is expected to extend research on the extent at which cancer and cancer treatments are associated with neurocognitive changes among non-CNS cancer patients and their impact on their quality of life in the local context. The results are expected to inform treatment providers to develop treatment guidelines tailored for individuals diagnosed with cancer and who have received cancer treatment, as well as individualized psychosocial interventions aimed at addressing psychological challenges associated with quality of life among cancer survivors.
背景
对中枢神经系统（CNS）恶性肿瘤的关注掩盖了虽少但却重要的研究，这些研究表明非中枢神经系统癌症患者会经历癌症相关认知障碍（CRCI），这会影响高阶脑功能并影响他们的生活质量。尽管有证据表明非CNS癌症患者中存在CRCI，但与CRCI相关的因素仍是一个备受争议的问题，存在诸多差异。非CNS癌症本身是否能独立于癌症治疗影响大脑是一个需要剖析的重要问题。这需要进一步研究，尤其是在证据有限的撒哈拉以南地区。
方法
本研究旨在评估化疗对非CNS癌症患者认知和情感变化的影响。将采用非实验性、时间序列、相关性设计，其中将进行一系列计算机化神经心理学测试，包括电子蒙特利尔认知评估量表（e-MoCA）、中枢神经系统生命体征、患者健康问卷-4、流行病学研究中心抑郁量表、汉密尔顿焦虑量表、癌症治疗功能评估-疲劳量表以及半结构化访谈提纲。将进行描述性和推断性统计分析，以及对定性数据的NVivo主题分析。本研究可以确定发展中环境下癌症患者及其幸存者中可能存在的神经认知问题和风险因素的范围。
意义
该研究有望扩展关于癌症及癌症治疗与非CNS癌症患者神经认知变化的关联程度及其对当地生活质量影响的研究。预期结果将为治疗提供者提供信息，以制定针对被诊断患有癌症并接受过癌症治疗的个体的治疗指南，以及旨在应对癌症幸存者生活质量相关心理挑战的个性化心理社会干预措施。
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