Pembroke Lorna, Sherman Kerry A, Francis Heather, Dhillon Haryana M, Gurney Howard, Gillatt David
Lifespan Health and Wellbeing Research Centre, Macquarie University, Macquarie Park, NSW, 2109, Australia.
School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University & Macquarie University Hospital, Macquarie Park, NSW, 2109, Australia.
Neuropsychol Rev. 2024 Apr 20. doi: 10.1007/s11065-024-09639-1.
Hormonal treatments (HT) for prostate cancer (e.g., androgen deprivation therapy) yield clinical and survival benefits, yet adverse cognitive changes may be a side effect. Since psychosocial factors are largely modifiable, interventions targeting these factors may help mitigate these adverse cognitive effects. This systematic review aimed to identify a range of psychosocial factors associated with cognitive function in individuals with prostate cancer undergoing HT and to determine whether these factors mitigate or exacerbate this effect. Applying PRISMA guidelines, a comprehensive search of relevant databases conducted in September 2023 using terms related to prostate cancer, hormone therapy, and cognitive outcomes was undertaken. The search yielded 694 unique abstracts, with 11 studies included for analysis examining the relationship between cognitive function and the following psychosocial factors: psychological distress, fatigue, insomnia, and coping processes. Findings were mixed with only two studies reporting significant associations between cognitive performance with fatigue and depression. Three studies that included measures of perceived cognitive function identified associations with depression, anxiety, fatigue, insomnia, illness threat appraisals, and coping styles. However, no studies found evidence for an association between self-reported and objective measures of cognitive functioning. Evidence regarding the association of interpersonal factors is lacking. Moreover, whether these factors mitigate or exacerbate the effect of HT on cognitive function still needs to be determined. Overall, the research exploring the association between psychosocial factors and cognitive function in prostate cancer survivors undergoing HT is still in its infancy. Further research is required to optimize the implementation of neuropsychological interventions for prostate cancer survivors.
前列腺癌的激素治疗（HT，例如雄激素剥夺疗法）可带来临床和生存益处，但不良认知变化可能是一种副作用。由于社会心理因素在很大程度上是可改变的，针对这些因素的干预措施可能有助于减轻这些不良认知影响。本系统评价旨在确定一系列与接受HT的前列腺癌患者认知功能相关的社会心理因素，并确定这些因素是减轻还是加剧这种影响。应用PRISMA指南，于2023年9月使用与前列腺癌、激素治疗和认知结果相关的术语对相关数据库进行了全面检索。检索得到694篇独特摘要，纳入11项研究进行分析，以考察认知功能与以下社会心理因素之间的关系：心理困扰、疲劳、失眠和应对过程。研究结果不一，只有两项研究报告了认知表现与疲劳和抑郁之间存在显著关联。三项纳入了感知认知功能测量的研究确定了与抑郁、焦虑、疲劳、失眠、疾病威胁评估和应对方式之间的关联。然而，没有研究发现自我报告的认知功能与客观测量之间存在关联的证据。关于人际因素关联的证据不足。此外，这些因素是减轻还是加剧HT对认知功能的影响仍有待确定。总体而言，探索接受HT的前列腺癌幸存者社会心理因素与认知功能之间关联的研究仍处于起步阶段。需要进一步研究以优化对前列腺癌幸存者的神经心理学干预措施的实施。
