Short-Term Effects of Treatment-Induced Hormonal Changes on Cognitive Function in Breast Cancer Patients Results of a Multicenter, Prospective, Longitudinal Study

被引:72
作者
Hermelink, Kerstin [1 ]
Henschel, Volkmar [2 ]
Untch, Michael [3 ]
Bauerfeind, Ingo [1 ]
Patrick, Michael [4 ]
Munzel, Karin [5 ]
机构
[1] Univ Munich, Frauenklin, Dept Gynecol & Obstet, D-81377 Munich, Germany
[2] Univ Munich, Inst Med Informat & Biometry, D-81377 Munich, Germany
[3] Helios Clin Berlin Buch, Dept Gynecol & Obstet, Berlin, Germany
[4] Univ Erlangen Nurnberg, Dept Gynecol & Obstet, Erlangen, Germany
[5] Univ Munich, Dept Psychol Neuropsychol, Munich, Germany
关键词
cognition disorders; breast neoplasms; hormone antagonists; adverse effects; menopause; neuropsychological tests; antineoplastic combined chemotherapy protocols;
D O I
10.1002/cncr.23853
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND. It is suspected that estrogen depletion resulting from treatment may contribute to cognitive compromise in patients with breast cancer. However, the evidence for estrogen effects oil cognition is inconclusive, and the consequences of hormonal changes for cognitive function in patients with cancer rarely have been investigated. In this study, the anthers investigated the effects of treatment-induced menopause and antiestrogen therapy with tamoxifen and aromatase inhibitors (AIs) oil cognitive function. METHODS. Cognitive performance was assessed in 101 patients with breast cancer before the start of cancer therapy (T1), toward the end of neoadjuvant chemotherapy (T2), and 1 year after baseline (T3) using 12 cognitive tests. Menopause occured in a subgroup of patients, and an overlapping subgroup started antiestrogen therapy with tamoxifen or AIs. Linear mixed-effects models that made it possible to determine effects at group levels and individual levels simultaneously were used for statistical analysis. RESULTS. At the group level, a significant favorable effect of induced menopause emerged in a test of executive function (P = .0035). Two additional group-level effects of induced menopause, both favorable, and 2 individual-level effects that were positive in some patients and negative in others were not significant when multiple testing was taken into account. No significant effects of tamoxifen or AIs on cognitive function were observed. CONCLUSIONS. Hormonal changes did not appear to contribute to cognitive compromise in patients with breast cancer during the first year after diagnosis. Antiestrogen treatment with tamoxifen or AIs did not affect cognition, and the effects of induced mnopause were more likely to be favorable. However, the possibility that some cognitive decline occurs in individual patients could not be excluded. Cancer 2008;113:2431-9. (C) 2008 American Cancer Society.
引用
收藏
页码:2431 / 2439
页数:9
相关论文
共 49 条
  • [1] Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma
    Ahles, TA
    Saykin, AJ
    Furstenberg, CT
    Cole, B
    Mott, LA
    Skalla, K
    Whedon, MB
    Bivens, S
    Mitchell, T
    Greenberg, ER
    Silberfarb, PM
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2002, 20 (02) : 485 - 493
  • [2] Cognitive function in breast cancer patients prior to adjuvant treatment
    Ahles, Tim A.
    Saykin, Andrew J.
    McDonald, Brenna C.
    Furstenberg, Charlotte T.
    Cole, Bernard F.
    Hanscom, Brett S.
    Mulrooney, Tamsin J.
    Schwartz, Gary N.
    Kaufman, Peter A.
    [J]. BREAST CANCER RESEARCH AND TREATMENT, 2008, 110 (01) : 143 - 152
  • [3] [Anonymous], WMS R WECHSLER GEDAC
  • [4] [Anonymous], 1994, HAWIE R HAMBURG WECH
  • [5] [Anonymous], 2000, RWT REGENSBURGER WOR
  • [6] Cognitive impairment associated with adjuvant therapy in breast cancer
    Bender, Catherine M.
    Sereika, Susan M.
    Berga, Sarah L.
    Vogel, Victor G.
    Brufsky, Adam M.
    Paraskar, Karen K.
    Ryan, Christopher M.
    [J]. PSYCHO-ONCOLOGY, 2006, 15 (05) : 422 - 430
  • [7] Memory impairments with adjuvant anastrozole versus tamoxifen in women with early-stage breast cancer
    Bender, Catherine M.
    Sereika, Susan M.
    Brufsky, Adam M.
    Ryan, Christopher M.
    Vogel, Victor G.
    Rastogi, Priya
    Cohen, Susan M.
    Casillo, Frances E.
    Berga, Sarah L.
    [J]. MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY, 2007, 14 (06): : 995 - 998
  • [8] Cognitive function in breast cancer patients receiving adjuvant chemotherapy
    Brezden, CB
    Phillips, KA
    Abdolell, M
    Bunston, T
    Tannock, IF
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2000, 18 (14) : 2695 - 2701
  • [9] Brickenkamp R, 2002, TEST D2 AUFMERKSAMKE
  • [10] BRINTON RD, 2006, EFFECTS ESTROGEN BRA, P116