Cancer Res Treat.  2021 Oct;53(4):1134-1147. 10.4143/crt.2020.1191.

Neurocognitive Effects of Chemotherapy for Colorectal Cancer: A Systematic Review and a Meta-Analysis of 11 Studies

• Hwang SY
• Kim K
• Ha B
• Lee D
• Kim S
• Ryu S
• Yang J
• Jung SJ

• KMID: 2521588
• DOI: http://doi.org/10.4143/crt.2020.1191

Abstract

Purpose
Chemotherapy-related cognitive impairment (CRCI) is a controversial concept not much explored on colorectal cancer patients.
Materials and Methods
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.
Results
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).
Conclusion
Chemotherapy has an overall positive negligible effect size on the cognitive function of colorectal patients. Age is a significant moderator of CRCI.

Keyword

Cognitive dysfunction; Colorectal neoplasms; Drug therapy; Meta-analysis

Figure

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  Fig. 1 Flow chart for inclusion of articles for meta-analysis.

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  Fig. 2 Standardized mean differences for changes in neurocognitive function after chemotherapy in colorectal cancer patients (n=706). CI, confidence interval; SMD, standardized mean difference.

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  Fig. 3 Funnel plot of studies included in the final analyses.

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  Fig. 4 Meta-regression plots for mean age of participant versus standardized mean difference.

Reference

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