Cognitive Complaints After Breast Cancer Treatments: Examining the Relationship With Neuropsychological Test Performance

被引：165

作者：

Ganz, Patricia A. ^{[1
,3
,4
]}

Kwan, Lorna ^{[3
]}

Castellon, Steven A. ^{[7
,9
]}

Oppenheim, Amy ^{[3
]}

Bower, Julienne E. ^{[6
,7
,8
]}

Silverman, Daniel H. S. ^{[5
]}

Cole, Steve W. ^{[4
,8
]}

Irwin, Michael R. ^{[6
,7
,8
]}

Ancoli-Israel, Sonia ^{[10
,11
]}

Belin, Thomas R. ^{[2
]}

机构：

[1] Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Hlth Policy & Management, Los Angeles, CA 90095 USA

[2] Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Biostat, Los Angeles, CA 90095 USA

[3] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Div Canc Prevent & Control Res, Los Angeles, CA 90095 USA

[4] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA

[5] Univ Calif Los Angeles, David Geffen Sch Med, Dept Mol & Med Pharmacol, Los Angeles, CA 90095 USA

[6] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA

[7] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90095 USA

[8] Univ Calif Los Angeles, Semel Inst, Cousins Ctr Psychoneuroimmunol, Los Angeles, CA 90095 USA

[9] VA Greater Los Angeles Hlth Care Syst, Dept Psychiat & Mental Hlth, Los Angeles, CA USA

[10] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA

[11] Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA

来源：

JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2013年 / 105卷 / 11期

基金：

美国国家卫生研究院;

关键词：

ADJUVANT CHEMOTHERAPY; SYSTEMIC CHEMOTHERAPY; MEMORY PERFORMANCE; VERBAL MEMORY; WOMEN; DYSFUNCTION; SURVIVORS; SYMPTOMS; IMPAIRMENT; VALIDATION;

D O I：

10.1093/jnci/djt073

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Cognitive complaints are reported frequently after breast cancer treatments. Their association with neuropsychological (NP) test performance is not well-established. Early-stage, posttreatment breast cancer patients were enrolled in a prospective, longitudinal, cohort study prior to starting endocrine therapy. Evaluation included an NP test battery and self-report questionnaires assessing symptoms, including cognitive complaints. Multivariable regression models assessed associations among cognitive complaints, mood, treatment exposures, and NP test performance. One hundred eighty-nine breast cancer patients, aged 2165 years, completed the evaluation; 23.3% endorsed higher memory complaints and 19.0% reported higher executive function complaints (> 1 SD above the mean for healthy control sample). Regression modeling demonstrated a statistically significant association of higher memory complaints with combined chemotherapy and radiation treatments (P .01), poorer NP verbal memory performance (P .02), and higher depressive symptoms (P < .001), controlling for age and IQ. For executive functioning complaints, multivariable modeling controlling for age, IQ, and other confounds demonstrated statistically significant associations with better NP visual memory performance (P .03) and higher depressive symptoms (P < .001), whereas combined chemotherapy and radiation treatment (P .05) approached statistical significance. About one in five postadjuvant treatment breast cancer patients had elevated memory and/or executive function complaints that were statistically significantly associated with domain-specific NP test performances and depressive symptoms; combined chemotherapy and radiation treatment was also statistically significantly associated with memory complaints. These results and other emerging studies suggest that subjective cognitive complaints in part reflect objective NP performance, although their etiology and biology appear to be multifactorial, motivating further transdisciplinary research.

引用

页码：791 / 801

页数：11

共 52 条

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