J Korean Acad Nurs.  2012 Oct;42(5):644-658. 10.4040/jkan.2012.42.5.644.

A Meta-analysis of Chemotherapy related Cognitive Impairment in Patients with Breast Cancer

Affiliations
  • 1College of Nursing, Ajou University, Suwon, Korea.
  • 2College of Nursing, Yonsei University, Seoul, Korea. baega7695@hanmail.net

Abstract

PURPOSE
The purpose of this study was to evaluate the cognitive effects of chemotherapy in patients with breast cancer.
METHODS
Using several databases, prospective studies were collected up to August 2011. Of 2,106 publications identified, 12 met the inclusion criteria, and 8 studies were used to estimate the effect size of chemotherapy on cognitive impairment.
RESULTS
Twelve studies were done since 2005 and most of the research was performed in Europe or North America. Eight studies were used to generate effect size across the cognitive domains of attention/concentration, verbal and visual memory, executive function, visuospatial skill, language, and subjective cognitive function. Each of the cognitive domains showed small effect sizes (-0.02 ~ -0.26), indicating diminished cognitive function for the chemotherapy group compared with non-chemotherapy groups.
CONCLUSION
Finding suggests that breast cancer patients who undergo chemotherapy may experience mild cognitive decline. Further study is needed to generate knowledge and guideline for interventions to address chemotherapy related cognitive impairment in these patients.

Keyword

Chemotherapy; Mild cognitive impairment; Attention; Memory; Breast neoplasms

MeSH Terms

Antineoplastic Agents/adverse effects/*therapeutic use
Breast Neoplasms/*drug therapy
Cognition Disorders/*physiopathology
Databases, Factual
Female
Humans
Language Tests
Memory, Short-Term
Neuropsychological Tests
Antineoplastic Agents

Figure

  • Figure 1. Flow diagram of study screening.


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Yoon Jung Kim, Sook Jung Kang
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Changes of Cognitive Function and Fatigue following Chemotherapy in Patients with Gastrointestinal Cancer: A Prospective Controlled Study
Pok-Ja Oh, Sun Mi Moon
Asian Oncol Nurs. 2019;19(3):126-134.    doi: 10.5388/aon.2019.19.3.126.


Reference

References

Ahles T. A.., Saykin A.J. 2002. Breast cancer chemotherapy-related cognitive dysfunction. Clinical Breast Cancer. 3(Suppl 3):S84–S90. http://dx.doi.org/10.3816/CBC.2002.s.018.
Article
Ahles T. A.., Saykin A. J.., McDonald B. C.., Li Y.., Furstenberg C. T.., Hanscom B. S., et al2010. Longitudinal assessment of cognitive changes associated with adjuvant treatment for breast cancer: Impact of age and cognitive reserve. Journal of Clinical Oncology. 28:4434–4440. http://dx.doi.org/10.1200/JCO.2009.27.0827.
Article
Bender C. M.., Sereika S. M.., Berga S. L.., Vogel V. G.., Brufsky A. M.., Paraska K. K., et al2006. Cognitive impairment associated with adjuvant therapy in breast cancer. Psycho-Oncology. 15:422–430. http://dx.doi.org/10.1002/pon.964.
Article
Braver T. S.., Barch D.M. 2002. A theory of cognitive control, aging cognition, and neuromodulation. Neuroscience and Biobehavioral Reviews. 26:809–817. http://dx.doi.org/10.1016/S0149-7634(02)00067-2.
Article
Collins B.., Mackenzie J.., Stewart A.., Bielajew C.., Verma, S. 2009. Cognitive effects of chemotherapy in post-menopausal breast cancer patients 1 year after treatment. Psycho-Oncology. 18:134–143. http://dx.doi.org/10.1002/pon.1379.
Article
Cusimano, A. 2001. Learning disabilities: There is a cure. Pennsylvania, PA: Achieve Publications.
Debess J.., Riis J. Ø.., Engebjerg M. C.., Ewertz, M. 2010. Cognitive function after adjuvant treatment for early breast cancer: A population-based longitudinal study. Breast Cancer Research and Treatment. 121:91–100. http://dx.doi.org/10.1007/s10549-010-0756-8.
Article
DerSimonian R.., Laird, N. 1986. Meta-analysis in clinical trials. Controlled Clinical Trials. 7:177–188. http://dx.doi.org/10.1016/0197-2456(86)90046-2.
Article
Egger M.., Davey Smith G. D.., Schneider M.., Minder, C. 1997. Bias in meta-analysis detected by a simple, graphical test. British Medical Journal. 315:629–634. http://dx.doi.org/10.1136/bmj.315.7109.629.
Article
Falleti M. G.., Sanfilippo A.., Maruff P.., Weih L.., Phillips K.A. 2005. The nature and severity of cognitive impairment associated with adjuvant chemotherapy in women with breast cancer: A meta-analysis of the current literature. Brain and Cognition. 59:60–70. http://dx.doi.org/10.1016/j.bandc.2005.05.001.
Article
Fan H. G.., Houédé-Tchen N.., Yi Q. L.., Chemerynsky I.., Downie F. P.., Sa-bate K., et al2005. Fatigue, menopausal symptoms, and cognitive function in women after adjuvant chemotherapy for breast cancer: 1-and 2-year follow-up of a prospective controlled study. Journal of Clinical Oncology. 23:8025–8032. http://dx.doi.org/10.1200/JCO.2005.01.6550.
Gazzaniga M. S.., Ivry R. B.., Mangun G.R. 2002. Cognitive neuroscience: The biology of the mind. 2nd ed.New York, NY: W.W. Norton & Company.
Glogoski C.., Milligan N. V.., Wheatley C.J. 2006. Evaluation and treatment of cognitive dysfunction. Pendleton H.M., Schultz- Krohn W., editorsPedretti’s occupational therapy: Practice skills for physical dysfunction. 6th ed.p. 589–608. St. Louis, MO: Mosby Elsevier.
Isaki E.., Spaulding T. J.., Plante, E. 2008. Contributions of language and memory demands to verbal memory performance in language-learning disabilities. Journal of Communication Disorders. 41:512–530. http://dx.doi.org/10.1016/j.jcomdis.2008.03.006.
Article
Jansen C. E.., Miaskowski C. A.., Dodd M. J.., Dowling G.A. 2007. A meta-analysis of the sensitivity of various neuropsychological tests used to detect chemotherapy-induced cognitive impairment in patients with breast cancer. Oncology Nursing Forum. 34:997–1005. http://dx.doi.org/10.1188/07.ONF.997-1005.
Article
Kim G. D.., Chung B. Y.., Kim K. H.., Byun H. S.., Choi E.H. 2011. Analysis of a trend of instrument usage to assess cognitive function of breast cancer patients undergoing chemotherapy. Journal of Korean Oncology Nursing. 11:179–185. http://dx.doi.org/10.5388/jkon.2011.11.3.179.
Article
Knobf M.T. 2011. Clinical update: Psychosocial responses in breast cancer survivors. Seminars in Oncology Nursing. 27:e1–e14. http://dx.doi.org/10.1016/j.soncn.2011.05.001.
Article
Korean National Statistical Office. 2009. Annual report on cause of death statistics. Seoul: Author.
Lezak M. D.., Howieson D. B.., Loring D.W. 2004. Neuropsychological assessment. 4th ed.New York, NY: Oxford University Press.
Matsuda T.., Takayama T.., Tashiro M.., Nakamura Y.., Ohashi Y.., Shimo-zuma, K. 2005. Mild cognitive impairment after adjuvant chemotherapy in breast cancer patients-evaluation of appropriate research design and methodology to measure symptoms. Breast Cancer. 12:279–287. http://dx.doi.org/10.2325/jbcs.12.279.
Myers J.S. 2009. Chemotherapy-related cognitive impairment. Clinical Journal of Oncology Nursing. 13:413–421. http://dx.doi.org/10.1188/09.CJON.413-421.
Article
National Evidence-based Healthcare Collaborating Agency. 2011. NE-CA’s guidance for systematic review for new health technology assessment. Seoul: Author.
Nelson C. J.., Nandy N.., Roth A.J. 2007. Chemotherapy and cognitive deficits: Mechanisms, findings, and potential interventions. Palliative and Supportive Care. 5:273–280. http://dx.doi.org/10.1017/S1478951507000442.
Article
Noal S.., Levy C.., Hardouin A.., Rieux C.., Heutte N.., Ségura C., et al2011. One-year longitudinal study of fatigue, cognitive functions, and quality of life after adjuvant radiotherapy for breast cancer. International Journal of Radiation Oncology, Biology, Physics. 81:795–803. http://dx.doi.org/10.1016/j.ijrobp.2010.06.037.
Article
Ouimet L. A.., Stewart A.., Collins B.., Schindler D.., Bielajew, C. 2009. Measuring neuropsychological change following breast cancer treatment: An analysis of statistical models. Journal of Clinical and Experimental Neuropsychology. 31:73–89. http://dx.doi.org/10.1080/13803390801992725.
Article
Quesnel C.., Savard J.., Ivers, H. 2009. Cognitive impairments associated with breast cancer treatments: Results from a longitudinal study. Breast Cancer Research and Treatment. 116:113–123. http://dx.doi.org/10.1007/s10549-008-0114-2.
Article
Rosenthal, R. 1991. Meta-analytic procedures for social research. Newbury Park, CA: Sage Publications.
Scottish Intercollegiate Guidelines Network. 2011. SIGN 50: A guideline developer's handbook. Retrieved January, 11, 2012, from. http://www.sign.ac.uk/pdf/sign50.pdf.
Stewart A.., Bielajew C.., Collins B.., Parkinson M.., Tomiak, E. 2006. A meta-analysis of the neuropsychological effects of adjuvant chemotherapy treatment in women treated for breast cancer. The Clinical Neuropsychologist. 20:76–89. http://dx.doi.org/10.1080/138540491005875.
Article
Tager F. A.., McKinley P. S.., Schnabel F. R.., El-Tamer M.., Cheung Y. K.., Fang Y., et al2010. The cognitive effects of chemotherapy in post- menopausal breast cancer patients: A controlled longitudinal study. Breast cancer Research and Treatment. 123:25–34. http://dx.doi.org/10.1007/s10549-009-0606-8.
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