Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.
Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing, China.
Support Care Cancer. 2024 Sep 17;32(10):663. doi: 10.1007/s00520-024-08873-w.
Cancer-related cognitive impairment (CRCI) exerts a negative impact on the quality of life in lung cancer survivors. Risk factors for CRCI in lung cancer patients remain unclear.This study aimed to identify risk factors for CRCI in lung cancer patients.
A comprehensive literature search was conducted across PubMed, CINAHL, Web of Science, Wanfang, VIP Database, Embase, and China National Knowledge Infrastructure (CNKI) from their inception until March 10, 2024. Studies were screened, data extracted, and quality assessed using the Agency for Healthcare Research and Quality and Newcastle-Ottawa Scale. Meta-analysis was performed using RevMan 5.4, assessing risk factors through odds ratios (OR) with 95% confidence intervals (CIs).
The analysis was comprised of nine studies, including 1,305 patients. Seven studies were high quality, and two were moderate quality. Identified risk factors for CRCI in lung cancer patients included advanced age (OR = 3.51, 95%CI: 2.14-5.74, I = 0.0%), cranial irradiation (OR = 2.12, 95% CI: 1.39-3.22, I = 0.0%), anxiety (OR = 2.92, 95% CI: 1.65-5.25, I = 37%), and symptom cluster burden (OR = 4.85, 95% CI: 2.99-7.87, I = 0.0%). Physical activity (OR = 0.37, 95% CI; 0.23-0.58, I = 9.0%) was identified as a protective factor.
Advanced age, cranial irradiation, anxiety, and symptom cluster burden are significant risk factors for CRCI, while physical activity serves as a protective factor. These insights provide healthcare professionals with an evidence-based framework for managing CRCI in lung cancer patients.
癌症相关认知障碍（CRCI）会降低肺癌幸存者的生活质量。肺癌患者发生 CRCI 的危险因素尚不清楚。本研究旨在确定肺癌患者发生 CRCI 的危险因素。
从建库至 2024 年 3 月 10 日，通过 PubMed、CINAHL、Web of Science、万方、维普、Embase 和中国知网（CNKI）全面检索文献。采用美国卫生保健研究与质量局和纽卡斯尔-渥太华量表筛选、提取和评价数据。采用 RevMan 5.4 进行荟萃分析，采用比值比（OR）及其 95%置信区间（CI）评估危险因素。
分析纳入 9 项研究，共 1305 例患者。其中 7 项研究质量较高，2 项研究质量中等。肺癌患者发生 CRCI 的危险因素包括高龄（OR=3.51，95%CI：2.14-5.74，I²=0.0%）、颅脑放疗（OR=2.12，95%CI：1.39-3.22，I²=0.0%）、焦虑（OR=2.92，95%CI：1.65-5.25，I²=37%）和症状群负担（OR=4.85，95%CI：2.99-7.87，I²=0.0%）。身体活动（OR=0.37，95%CI：0.23-0.58，I²=9.0%）是保护因素。
高龄、颅脑放疗、焦虑和症状群负担是 CRCI 的显著危险因素，而身体活动是保护因素。这些发现为临床医护人员提供了管理肺癌患者 CRCI 的循证框架。
